成人良性食管气管支气管瘘的诊断和治疗

The diaguosis and treatment of benin esophagotra-cheo-bronchial fistula: a report of 26 cases

１９６０～１９９１年作者共收治良性食管气管瘘和食管支气管瘘患者２６例，多为外伤或憩室所致。手术治疗２３例，术后均恢复正常进食。为避免肺部并发症，此病一俟诊断明确即应尽早手术。食管瘘和气管、支气管瘘分别修补后用胸膜或肌瓣间置可有效地预防复发。本文还报告２例罕见的巨大食管气管疹的治疗经验。

AbstractTwenty six patients with esophagotracheal fistulaor esophagobronchial fistula were treated from 1960 to1991.There were 18 males and 8 females with ageranging from 19 to 69.Trauma and complication ofesophageal diverticulum were the main causes of fistu-la. Among 23 patients surgically treated,10 underwentdirect repair,and 13 either closure of esophageal defector tracheal or bronchial defect.The concomitant pro-cedures were permanent tracheostomy,tracheal resec-tion and reconstruction,pulmonary resection,thora-coplasty esophagectomy,and esophagogastric anasto-mosis,All patients resumed normal eating. Complica-tions included paralysis of recurrent nerves,empyema,injury and ligation of subclavian artery,dehiscence oftracheal anastomosis,and contralateral pneumohy-drothorax in each patient.Prognosis of 3 nonsurgicaltreatments of fistulas was poor. Surgical interventionshould be done as soon as the diagnosis is establishedin order to minimize pulmonary complication.