Włodarczyk Janusz, Smęder Tomasz, Obarski Piotr, Ziętkiewicz Mirosław
Department of Thoracic and Surgical Oncology, Jagiellonian University Collegium Medicum, John Paul II Hospital, 31-202 Cracow, Poland.
Department of Thoracic and Surgical Oncology, John Paul II Hospital, 31-202 Cracow, Poland.
Healthcare (Basel). 2023 Dec 14;11(24):3165. doi: 10.3390/healthcare11243165.
(1) Background: Esophago-airway fistula after esophageal resection is a rare, life-threatening complication associated with a high postoperative mortality rate. Managing this condition is challenging, and the prognosis for patients is uncertain. The results and our own approach to treatment are presented. (2) Material and Methods: We present a retrospective analysis of a group of 22 patients treated for an esophago-airway fistula between 2012 and 2022, with 21 cases after esophageal resection and one during the course of Hodgkin's disease. (3) Results: Twenty-two patients were treated for an esophago-airway fistula. Among them, a tracheobronchial fistula occurred in 21 (95.4%) patients during the postoperative period, while 1 (4.5%) was treated for Hodgkin's disease. Of these cases, 17 (70.7%) patients underwent esophageal diversion with various treatments, including intercostal flap in most cases, greater omentum in one (4.5%), latissimus dorsi muscle in two (9%), and greater pectoral muscle in one (4.5%). Esophageal stenting was performed in two patients (9.0%), and one (4.5%) was treated conservatively. Unfortunately, one patient (4.5%) died after being treated with bronchial stenting, and two (9.5%) experienced a recurrence of the fistula. (4) Conclusions: The occurrence of an esophago-airway fistula after esophagectomy is a rare but life-threatening complication with an uncertain prognosis that results in several serious perioperative sequelae.
(1) 背景:食管切除术后食管气道瘘是一种罕见的、危及生命的并发症,术后死亡率高。处理这种情况具有挑战性,患者的预后也不确定。本文介绍了相关结果及我们自己的治疗方法。(2) 材料与方法:我们对2012年至2022年间接受食管气道瘘治疗的22例患者进行了回顾性分析,其中21例为食管切除术后病例,1例为霍奇金病病程中出现的病例。(3) 结果:22例患者接受了食管气道瘘治疗。其中,21例(95.4%)患者在术后出现气管支气管瘘,1例(4.5%)因霍奇金病接受治疗。在这些病例中,17例(70.7%)患者接受了食管改道及各种治疗,多数情况下采用肋间皮瓣,1例(4.5%)采用大网膜,2例(9%)采用背阔肌,1例(4.5%)采用胸大肌。2例患者(9.0%)进行了食管支架置入,1例(4.5%)采用保守治疗。不幸的是,1例患者(4.5%)在接受支气管支架置入治疗后死亡,2例(9.5%)出现瘘复发。(4) 结论:食管切除术后食管气道瘘的发生是一种罕见但危及生命的并发症,预后不确定,会导致多种严重的围手术期后遗症。