Cancura W
Laryngol Rhinol Otol (Stuttg). 1978 Jul;57(7):597-601.
Esophago-tracheal fistulae develop to an increasing extent due to the long-term intubation in intensive-care patients. Their treatment is usually problematic, since the general condition of the patient, weakened by his basic disease, very often does not permit any major intervention; in addition, the topographical location of the fistula makes the access to it even more difficult. In one patient two attempts failed to close the fistula from an extended tracheostomy. The narrow access passage between the anaesthetic tube and the tracheal wall did not permit an exact suture; the heavy formation of scars in the fistular environment did not permit either a preparation in layers or the shift of mucosal flaps for coverage. However, a fistula was successfully closed from a collar mediastinotomy. With normal tracheal width, unrestricted esophagus function was restored without damage to the recurrent laryngeal nerve. The advantages of this surgical method are discussed in greater detail.
由于重症监护患者长期插管，食管气管瘘的发生率日益增加。其治疗通常存在问题，因为患者的总体状况因基础疾病而虚弱，往往不允许进行任何重大干预；此外，瘘管的位置使得接近它更加困难。在一名患者中，两次尝试通过扩大气管切开术闭合瘘管均失败。麻醉管与气管壁之间狭窄的通路不允许精确缝合；瘘管周围大量瘢痕形成既不允许分层准备，也不允许黏膜瓣移位覆盖。然而，通过颈部纵隔切开术成功闭合了瘘管。在气管宽度正常的情况下，恢复了正常的食管功能，且未损伤喉返神经。对这种手术方法的优点进行了更详细的讨论。
