Fukai I, Niwa T, Takagi I, Yokochi T, Iwata H, Moriyama S
Department of Surgery, Sakishima Hospital, Mie, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Mar;43(3):413-6.
We have treated a 58-year-old man with almost complete tracheal occlusion arising as a result of recurrence of esophageal cancer. Although laser photoresection using partial cardiopulmonary bypass was desirable, neither laser nor cardiopulmonary bypass was available in our hospital. It was then decided to resect the tumor by forceps. In order to prevent bleeding from tumor during such emergency procedure, intratumoral injection of ethanol was preceded and tracheal lumen could be opened successfully. He was managed by insertion of a Dumon silicone stent seven days after the emergency. The result was satisfactory for maintaining the patency of the airway where the stent was placed. Unfortunately the patient died 113 days after the insertion of Dumon silicone stent from massive hemoptysis, which might resulted from the rupture of vessel feeding the tumor or the perforation of aorta involved by the tumor.
我们治疗了一名58岁男性,其因食管癌复发导致几乎完全性气管阻塞。尽管使用部分体外循环的激光光切除术是理想的,但我院既没有激光设备也没有体外循环设备。于是决定用钳子切除肿瘤。为了在这种紧急手术中防止肿瘤出血,先进行了瘤内注射乙醇,成功打开了气管腔。在紧急手术后7天,给他置入了一个杜蒙硅酮支架。支架置入部位气道的通畅维持情况令人满意。不幸的是,患者在置入杜蒙硅酮支架113天后死于大量咯血,这可能是由于肿瘤供血血管破裂或肿瘤累及主动脉穿孔所致。