H型食管气管瘘经颈修补术

Repair of H-type tracheoesophageal fistula through cervical approach

目的 探讨H型食管气管瘘的诊断方法 ,介绍经颈部入路行瘘管切断修补术。方法 本院 2 0年来收治了 5例先天性H型食管气管瘘 ,并经碘油造影、气管内滴注美兰法及Johonston法等检查证实。 5例均经颈部切口入路行瘘管修补术。结果 1例术后声音嘶哑 ,3个月后好转 ;4例曾发生术后吸气性喉鸣 ,3例出院时好转 ,1例半年后好转 ;5例痊愈出院。结论 H型食管气管瘘临床少见 ,检查手段需进一步提高 ,临床确诊后 。

Objective To explore the diagnosis of H-type tracheoesophageal fistula and repairing through cervical approach. Methods The diagnosis of 5 cases with H-type tracheoesophageal fistula were confirmed by iodized oil roentgenograph, intratracheal methylene blue infusion and Johnston's methods. The tracheoesophageal fistula were successfully divided through cervical approach.Results All 5 cases have recovered. But one patient complicated with hoarseness and improved after 3 months, 4 cases had inspiratory laryngeal stridor and improved at discharge (3) or 6 months later (1).Conclusions H-type tracheoesophageal fistula is a rare condition and the examination techniques need to be further improved. Once definite diagnosis is established, a cervical transverse approach can provide satisfactory exposure.