Bramhall S R, Veitch P S, Gourevitch D, Wicks A C
Department of Surgery, Leicester General Hospital.
Ann R Coll Surg Engl. 1993 May;75(3):189-92.
The authors describe a method of inserting an Atkinson tube using a flexible upper gastrointestinal endoscope which does not require the use of X-ray screening. A retrospective review of 50 patients intubated by this technique has been undertaken and the results presented. Of the lesions, 40% were squamous cell carcinoma and 40% adenocarcinoma, with 84% being situated in the lower third of the oesophagus; 94% of patients only required one intubation. The two major complications of the procedure are tube displacement and oesophageal leak; a tube displacement rate of 13% was recorded, comparable with other series. Eleven patients (20.8%) were found to have an oesophageal leak, but this resulted in death in only three patients (6%). The reasons for these figures are explained. An operative mortality rate of 12% is comparable with series using other methods. The authors conclude that this method of intubation is as safe as Atkinson's original method but has the advantage that X-ray screening is not required.
作者描述了一种使用可弯曲上消化道内窥镜插入阿特金森管的方法，该方法无需使用X线透视。对采用该技术插管的50例患者进行了回顾性研究并展示了结果。在这些病变中，40%为鳞状细胞癌，40%为腺癌，84%位于食管下三分之一处；94%的患者仅需一次插管。该操作的两个主要并发症是导管移位和食管漏；记录的导管移位率为13%，与其他系列相当。发现11例患者（20.8%）存在食管漏，但仅3例患者（6%）因此死亡。文中解释了这些数据的原因。12%的手术死亡率与使用其他方法的系列相当。作者得出结论，这种插管方法与阿特金森的原始方法一样安全，但优点是无需X线透视。
