Gerhardt H J
Head Neck Surg. 1981 Sep-Oct;4(1):64-8. doi: 10.1002/hed.2890040112.
A patient with a 1.5- to 2.5-cm tracheoesophageal fistula secondary to prolonged assisted ventilation and feeding by a nasogastric tube was operated upon by a transtracheal microsurgical approach. The advantages of this approach are as follows: (1) the surgery is not extensive and therefore does not cause much stress to the patient; (2) this technique avoids the necessity for a wide mediastinotomy or sternotomy and thoracotomy, and therefore averts the danger of a widespread infection with the highly antibiotic-resistant bacteria that are always present in these cases; and (3) there is no risk of damage to the recurrent nerve. The ENT surgeon who is well-trained and experienced in microsurgery should try this approach in selected cases first. If this method fails, other methods are still available.
一名因长期辅助通气和鼻胃管喂养继发1.5至2.5厘米气管食管瘘的患者接受了经气管显微手术入路治疗。该入路的优点如下：（1）手术范围不大，因此对患者造成的应激较小；（2）该技术避免了广泛的纵隔切开术、胸骨切开术和开胸术的必要性，从而避免了这些病例中始终存在的高耐抗生素细菌广泛感染的风险；（3）不存在损伤喉返神经的风险。训练有素且在显微手术方面经验丰富的耳鼻喉科医生应首先在选定的病例中尝试这种入路。如果这种方法失败，仍有其他方法可用。
