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后天性气管食管瘘：一种气管成形术的替代技术。

Acquired Benign Tracheoesophageal Fistula: An Alternative Tracheoplastic Technique.

机构信息

Department of Thoracic Surgery, Monaldi Hospital, Naples, Italy.

Department of Anesthesia and Intensive Care, Monaldi Hospital, Naples, Italy.

出版信息

Ann Thorac Cardiovasc Surg. 2022 Dec 20;28(6):377-380. doi: 10.5761/atcs.nm.22-00077. Epub 2022 Sep 3.

DOI:10.5761/atcs.nm.22-00077
PMID:36058880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9763712/
Abstract

We present a case of surgical management of a tracheoesophageal fistula (TEF) following prolonged intubation. After transverse tracheal division and retraction of the distal stump, direct closure of the esophageal defect and repair of the membranous tracheal defect using a synthetic bioabsorbable patch were performed, followed by interposition of muscle flap between the suture lines and tracheal reconstruction. Large TEFs, without tracheal stenosis or circumferential airway defect, associated with marked peritracheal inflammation, may be treated with this alternative tracheoplastic technique in patients deemed not suitable for tracheal resection and anastomosis.

摘要

我们报告了一例因长时间插管导致的气管食管瘘（TEF）的手术治疗。在横向气管切开和远端残端牵引后，使用合成可吸收补片直接关闭食管缺损，并修复膜性气管缺损，然后在缝线之间插入肌肉瓣进行气管重建。对于与明显的气管周围炎症相关的、无气管狭窄或环形气道缺损的大 TEF 患者，如果认为不适合进行气管切除和吻合术，则可以使用这种替代气管成形技术进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/aefb31227184/atcs-28-377-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/7799b19800c4/atcs-28-377-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/c96e216d17ec/atcs-28-377-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/aefb31227184/atcs-28-377-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/7799b19800c4/atcs-28-377-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/c96e216d17ec/atcs-28-377-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82ce/9763712/aefb31227184/atcs-28-377-g003.jpg

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本文引用的文献

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Repair of Adult Benign Tracheoesophageal Fistulae With Absorbable Patches: Single-Center Experience.成人良性气管食管瘘修复术：单中心经验。
Ann Thorac Surg. 2020 Apr;109(4):1086-1094. doi: 10.1016/j.athoracsur.2019.09.081. Epub 2019 Nov 22.
2
Early and late outcome after surgical treatment of acquired non-malignant tracheo-oesophageal fistulae.后天性非恶性气管-食管瘘的手术治疗的早期和晚期结果。
Eur J Cardiothorac Surg. 2013 Jun;43(6):e155-61. doi: 10.1093/ejcts/ezt069. Epub 2013 Feb 26.
3
Anastomotic complications after tracheal resection: prognostic factors and management.
气管切除术后的吻合口并发症：预后因素与处理
J Thorac Cardiovasc Surg. 2004 Nov;128(5):731-9. doi: 10.1016/j.jtcvs.2004.07.005.
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Tracheoesophageal fistula.气管食管瘘
Chest Surg Clin N Am. 2003 May;13(2):271-89. doi: 10.1016/s1052-3359(03)00030-9.
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Evaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas.气管插管后气管食管瘘不同手术技术的评估及结果
J Thorac Cardiovasc Surg. 2000 Feb;119(2):268-76. doi: 10.1016/S0022-5223(00)70182-6.