Akashi A, Ohashi S, Oriyama T, Kanno H, Sasaoka H, Sakamaki Y, Katsura T, Nishino M
Department of Surgery, Takarazuka City Hospital, Takarazuka, Hyogo, Japan.
Surg Laparosc Endosc. 1997 Dec;7(6):491-4.
Thoracoscopic fistulectomy and diverticulectomy for esophagobronchial fistula with esophageal diverticulum were performed on a 49-year-old-woman. The neck of the diverticulum and the fistula were divided with endo-stapling technique. Intraoperative esophagoscopy was found to be useful for the definite localization and complete excision of the fistula and the diverticulum and the avoidance of stenosis of the esophagus. To avoid the recurrence of fistula, a pedicle of viable mediastinal pleura was interposed between esophageal and bronchial closures. Postoperative course was uneventful, and the complete relief of symptom was experienced for a period of 10 months after the operation. It is to be considered that the present thoracoscopic procedure with intraoperative esophagoscopy can be used as a standard operative procedure for esophagobronchial fistula with esophageal diverticulum.
对一名49岁女性实施了胸腔镜下瘘管切除术和憩室切除术，用于治疗合并食管憩室的食管支气管瘘。采用内镜吻合器技术分离憩室颈部和瘘管。术中食管镜检查有助于明确瘘管和憩室的定位并完整切除，同时避免食管狭窄。为避免瘘管复发，在食管和支气管闭合处之间置入带蒂的存活纵隔胸膜。术后病程顺利，术后10个月症状完全缓解。可以认为，目前这种术中采用食管镜检查的胸腔镜手术可作为合并食管憩室的食管支气管瘘的标准手术方法。
