Hirao M, Shimada M, Kaneko T, Mizunoya S, Okagawa K
Department of Surgery, Kinki Central Hospital, Itami, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Nov;42(11):2144-9.
Two successful cases of endoscopic therapy for esophageal fistula are reported herein. The first case was a 61-year-old man who underwent irradiation, chemotherapy and endoscopic laser beam therapy for esophageal cancer (Im T4N0M0 Stage III). Gastrografin -esophagogram revealed a fistula between esophagus and mediastinum after these therapy. Closure of the fistula was attainable using fibrin glue with a double-channel-fiber scope. The second case was a 43-year-old man who underwent chemotherapy and irradiation for lung cancer (S1,S2 T4N2M0 Stage IIIB) which invaded to mediastinum, trachea and esophagus. Bronchogram revealed a esophago-tracheal fistula one month later. We performed the same procedure as the first case, and confirmed reduction of the fistulous size. The endoscopic fibrin glue injection is an easy, safe and effective technique for the fistula even caused by malignancies, and contributes to the quality of life of these patients.
本文报告了两例成功的内镜治疗食管瘘的病例。第一例是一名61岁男性，因食管癌（Im T4N0M0 III期）接受了放疗、化疗和内镜激光束治疗。这些治疗后，泛影葡胺食管造影显示食管与纵隔之间存在瘘管。使用双通道纤维内镜和纤维蛋白胶可实现瘘管闭合。第二例是一名43岁男性，因侵犯纵隔、气管和食管的肺癌（S1、S2 T4N2M0 IIIB期）接受了化疗和放疗。支气管造影显示一个月后出现食管气管瘘。我们采用了与第一例相同的手术方法，并证实瘘管大小缩小。内镜下注射纤维蛋白胶是一种简单、安全且有效的治疗瘘管的技术，即使瘘管是由恶性肿瘤引起的，也有助于提高这些患者的生活质量。
