De Giacomo T, Francioni F, Venuta F, Rendina E A, Ricci C
Cattedra di Chirurgia Toracica, Università degli Studi di Roma La Sapienza.
Minerva Chir. 1993 Apr 15;48(7):311-6.
Benign esophago-respiratory fistula is a relatively rare condition of great surgical interest because of its potential total curability. The ratio of benign to malignant fistula is around 1:5. Sometimes the diagnosis is difficult because of the non specific nature of presenting symptoms. This report concern 10 cases of benign esophagorespiratory fistulas observed during a period of twenty years. There were 6 esophago-tracheal fistulas and 4 esophagobronchial fistulas. In 4 cases the fistulas were congenital, in 1 the fistula was due to perforation of esophageal diverticulum and in 3 patient the fistula developed after prolonged intubation. All patient underwent surgical treatment consisted of division of the fistula and suture of both esophageal and respiratory defect. In 4 cases we performed pulmonary parenchyma resection because of irreversible inflammatory lesions. There were no perioperative death. One young patients with tubercular fistula developed a dehiscence of esophageal suture successfully treated with pleural drainage and several application of fibrin glue. All patient were considered to have very good results.
良性食管气管瘘是一种相对罕见的疾病,但因其具有潜在的完全可治愈性而备受外科关注。良性瘘与恶性瘘的比例约为1:5。有时由于症状缺乏特异性,诊断较为困难。本报告涉及20年间观察到的10例良性食管气管瘘病例。其中有6例食管气管瘘和4例食管支气管瘘。4例瘘为先天性,1例瘘是由于食管憩室穿孔所致,3例患者的瘘是在长时间插管后形成的。所有患者均接受了手术治疗,包括瘘管分离以及食管和呼吸道缺损的缝合。4例患者因不可逆的炎症病变进行了肺实质切除术。围手术期无死亡病例。1例患有结核性瘘的年轻患者食管缝合处出现裂开,经胸腔引流和多次应用纤维蛋白胶成功治愈。所有患者均被认为效果良好。