食管切除术后胃管穿孔穿透心包，需手术修复。
Gastric tube perforation penetrating the pericardium after esophagectomy that needed surgical repair.
作者信息
Akutsu Tomohiro, Endo Akira, Okuzawa Hiraaki, Suzuki Keisuke, Yonekawa Chisato, Hoshi Hiromasa, Otomo Yasuhiro
机构信息
Department of Acute Critical Care Medicine Tsuchiura Kyodo General Hospital Tsuchiura Japan.
Department of Acute Critical Care and Disaster Medicine Tokyo Medical and Dental University Graduate School of Medicine and Dental Sciences Tokyo Japan.
出版信息
Acute Med Surg. 2023 Jun 20;10(1):e861. doi: 10.1002/ams2.861. eCollection 2023 Jan-Dec.
BACKGROUND
As the prognosis of esophageal cancer surgery has improved, reports on postoperative complications of gastric tubes have increased. Among them, gastric tube ulcer perforation is infrequent but often severe and difficult to treat.
CASE PRESENTATION
A 73-year-old man had undergone thoracoscopic subtotal esophagectomy and laparoscopic-assisted gastric tube reconstruction via the retrosternal route for thoracic esophageal cancer 8 years previously. He was transferred to our hospital with a diagnosis of gastric tube ulcer perforation, penetrating the pericardium. Emergency surgery was performed to remove the gastric tube, followed by immediate reconstruction by right colon interposition. The patient was discharged on postoperative day 142.
CONCLUSION
We report a rare complication of gastric tube ulcer perforation, penetrating the pericardium, after esophagectomy for esophageal cancer. It was successfully treated with appropriate surgical management.
背景
随着食管癌手术预后的改善，关于胃管术后并发症的报道有所增加。其中，胃管溃疡穿孔虽不常见，但往往较为严重且难以治疗。
病例介绍
一名73岁男性8年前因胸段食管癌接受了胸腔镜下食管次全切除术及经胸骨后途径腹腔镜辅助胃管重建术。他因胃管溃疡穿孔并穿透心包被诊断而转入我院。急诊手术切除胃管，随后立即行右半结肠间置重建术。患者于术后第142天出院。
结论
我们报道了1例食管癌切除术后罕见的胃管溃疡穿孔并穿透心包的并发症。通过适当的手术处理成功治愈。
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