气道覆膜支架治疗胸腔胃-气道瘘48例临床分析

Clinical analysis of treating airway-thoracostomach fistulas by airway coated stents in 48 cases

目的 胸腔胃气道瘘临床治疗甚为棘手,本文旨在探讨气道覆膜金属支架封堵胸腔胃-气道瘘的疗效和安全性.方法 对经支气管镜放置气道覆膜支架治疗的48例胸腔胃-气管瘘患者进行回顾性分析,所有病例均为食管癌食管-胃弓上吻合术或颈部吻合术后,恶性胸腔胃-气道瘘45例,良性3例.结果 瘘口最大直径3～80 mm,放置覆膜支架53枚,其中直管型10枚,L型36枚,Y型7枚.瘘口封堵近期疗效：完全缓解9例（18.75％）,部分缓解34例（70.83％）,无效5例（10.42％）,总有效率为89.58％,中位生存时间为5个月.结论 气道覆膜金属支架封堵胸腔胃气道瘘近期疗效较好,且操作简单、安全.

Objective To evaluate the safety and clinical efficacy of airway coated stents for the treatment of airway-thoracostomach fistula under bronchoscopic guidance.Methods 48 cases of airwaythoracostomach fistula were analyzed retrospectively after treatment of airway coated metallic stents.All cases were esophageal cancer after stomach esophagus anastomosis or neck anastomosis surgery.Among the patients,45 cases were malignant airway-thoracostomach fistula and three cases were benign.Results The diameter of fistula orifices was 3 80 mm.A total of 53 airway coated stents （7 Y-shaped,36 L-shaped,and 10 cylinder） were placed.The short-term effect by airway coated stents：nine cases （18.75％） showed complete responses,34 cases （70.83％） showed partial responses,and five cases （10.42 ％） had no responses.The total effective rate was 89.58 ％,and the median survival duration of all the patients was five months.Conclusions The use of airway coated stents is proved to be feasible,safe,and effective for the palliative treatment of airway-thoracostomach fistulas.