Balkan M E, Ozdülger A, Tastepe I
Department of Thoracic Surgery, Atatürk Chest Diseases and Thoracic Surgery Center, Ankara, Turkey.
Scand Cardiovasc J. 1997;31(2):111-5. doi: 10.3109/14017439709058079.
Perforation of the thoracic esophagus can be fatal unless diagnosed promptly and treated effectively. The high mortality with delayed treatment is principally due to the inability of effectively closing the perforation and preventing the leakage. We operated one patient with a delayed diagnosis of thoracic esophageal perforation developed after a rigid esophagoscopic procedure. The perforation was closed with primary sutures and reinforced with a intercostal muscle flap wrap. Radical decortication and wide mediastinal and pleural toilet were also done. Total parenteral nutrition was begun and antibiotics were administered according to the results of cultures. Esophagography and esophagoscopy performed 10 days after the operation showed a well healed esophagus without stenosis or leakage. We conclude that primary closure of the perforation and muscle flap wrap can provide a one-stage operation with good results for repair of thoracic esophageal perforations which are not diagnosed on time.
除非能迅速诊断并有效治疗，胸段食管穿孔可能会致命。延迟治疗导致的高死亡率主要是由于无法有效闭合穿孔并防止渗漏。我们为一名在硬质食管镜检查后出现延迟诊断的胸段食管穿孔患者进行了手术。穿孔通过一期缝合关闭，并用肋间肌瓣包裹加固。还进行了根治性剥脱术以及广泛的纵隔和胸膜清创。开始给予全胃肠外营养，并根据培养结果使用抗生素。术后10天进行的食管造影和食管镜检查显示食管愈合良好，无狭窄或渗漏。我们得出结论，对于未能及时诊断的胸段食管穿孔，穿孔的一期闭合和肌瓣包裹可为修复提供一期手术且效果良好。
