Dumon支架治疗气道消化道瘘31例近期疗效观察

Short-term efficacy of Dumon stent in treating respiratory-digestive fistulas： a study of 31 patients

目的 探讨Dumon硅酮支架治疗气道消化道瘘的近期疗效及可行性。方法回顾性分析了在本中心经硬质支气管镜放置Dumon支架治疗的气道消化道瘘31例，包括气道食管瘘23例（气管食管瘘16例，左主支气管食管瘘6例，右中间支气管食管瘘1例），气道胸腔胃瘘6例（气管胸腔胃瘘3例，右主支气管胸腔胃瘘3例），气管吻合口瘘1例，同时有气管食管瘘、左主支气管吻合口瘘2个瘘口1例。支架置入后对患者的近期疗效进行评估。结果31例（32个瘘口）均成功植入支架，共放置Y型支架28枚，直管型支架3枚，沙漏状支架1枚。完全缓解15例（48．4％），部分缓解13例（41．9％），无效3例（9．7％），总有效率为90．3％。主要并发症有痰液潴留、肉芽增生、咳嗽、支架移位。结论Dumon硅酮支架治疗气道消化道瘘封堵瘘口效果良好，操作安全，并发症可接受。

Objective To estimate the efficacy and feasibility of Dumon stent in the treatment of respiratorydigestive fistulas. Methods 31 patients who used Dumon stent for treating the fistula in our centre were retrospectively analyzed, including 23 cases with airway-esophageal fistula, six cases with airway-gastric fistula,one case with airway-anastomotic fistula and one case with both tracheoesophageal fistula and left main bronchus-anastomotic fistula. After placing the Dumon stent, the short-term efficacy was evaluated according to our criteria. Results The Dumon stents were successfully placed in all the 31 cases （a total of 32 fistula orifices）, including 28 Y-shaped stents, three straight stents and one hourglassshaped stent. Based on the criteria, 15 cases （48.4%） achieved complete response, 13 cases （41.9%） achieved partial response and three cases （9.7% ） were failed treatment. The main complications included mucus obstruction, granulation tissue formation, cough and migration. No lethal complication was happened. Conclusions Dumon stent for respiratory-digestive fistulas is an effective and safe treatment.