并发症处理Ⅱ：腔道衰竭和腔道气道瘘

Managing Complications Ⅱ: Conduit Failure and Conduit Airway Fistulas

腔道衰竭和腔道气道瘘是食管切除后罕见的并发症,但可导致灾难性的后果,死亡率非常高。存活者的住院时间会延长,期间遭受更多的医疗干预,经历更久的时间来恢复经口进食。高度警惕有助于早期诊断。腔道衰竭常需要一段时间的近端食管转位及阶段性重建。腔道气道瘘可经内镜修复但失败率高,很多患者需要手术修复以关闭瘘口,并且填充血管丰富的组织以减少复发。

Conduit failure and conduit airway fistula are rare complications after esophagectomy, however they can be catastrophic resulting in high mortality. Survivors can expect a prolonged hospital course with multiple interventions and an extended period of time prior to being able to resume oral nutrition. High index of suspicion can aid in early diagnosis. Conduit failure usually requires a period of proximal esophageal diversion and staged reconstruction. Conduit airway fistulas may be amenable to endoscopic repair but this has a high failure rate and many patients will require surgical repair with closure of the fistula and interposition of vascularized tissue to minimize recurrence.