Infante M, Valente M, Andreani S, Catanese C, Dal Fante M, Pizzetti P, Giudice G, Basilico M, Spinelli P, Ravasi G
Surgery. 1996 Jan;119(1):46-50. doi: 10.1016/s0039-6060(96)80212-1.
The management of postoperative leaks into the mediastinum or pleural cavities after esophageal surgery yields unsatisfactory results. A recently described method, drainage of the mediastinum or pleural cavity through suture line defects, has been used in our department with eight patients.
A suction tube was advanced over an endoscopically placed guide wire into the abscess from inside the esophagus, and gentle aspiration was used to remove saliva and secretions. Intravenous antibiotics and total parenteral nutrition were also given.
The sepsis was rapidly controlled, and the abscess cavity progressively collapsed in all cases. Seven patients recovered and were discharged 34 to 61 days after operation; one died of concomitant complications.
This method seems promising for the management of intrathoracic esophageal leaks.
食管手术后纵隔或胸腔内术后漏的处理效果不尽人意。我们科室对8例患者采用了一种最近描述的方法，即通过缝线处缺损对纵隔或胸腔进行引流。
在内镜引导钢丝的引导下，将一根吸引管从食管内部插入脓肿，轻轻抽吸以清除唾液和分泌物。同时给予静脉抗生素和全胃肠外营养。
所有病例的脓毒症均迅速得到控制，脓肿腔逐渐缩小。7例患者康复，术后34至61天出院；1例死于并发的并发症。
这种方法在处理胸段食管漏方面似乎很有前景。
