PDF(Pubmed)
Abstract：
BACKGROUND: Tracheoesophageal fistula (TEF) especially malignant TEF (mTEF) is an uncommon yet critical medical condition necessitating immediate intervention. This life-threatening condition frequently manifests in critically ill patients who are dependent on prolonged mechanical ventilation and are unsuitable candidates for thoracotomy due to their compromised health status. The Management of these mTEF patients remain a significant challenge.This study aimed to evaluate the safety and efficacy of using a cardiac septal occluder for the closure of mTEF.
METHODS: 8 patients with mTEF underwent closure surgery using atrial/ventricular septal defect (ASD/VSD) septal occluders at the Respiratory Department of HuBei Yichang Central People\'s Hospital from 2021 to 2023. The procedure involved percutaneous placement of the occluder through the fistula to achieve closure.
RESULTS: The placement of the cardiac septal occluder was successfully achieved with ease and efficiency in all patients. The study demonstrated that the use of cardiac septal occluder therapy in patients with mTEF can alleviate symptoms, improve quality of life, and enhance survival rates, with no significant complications observed. Furthermore, the study provided comprehensive details on surgical indications, preoperative evaluation and diagnosis, selection of occluder, methods of occlusion, and postoperative care.
CONCLUSIONS: The application of cardiac septal occluder in the treatment of mTEF is a safe and effective palliative treatment. This approach may be particularly beneficial for patients with a high risk of complications and mortality associated with traditional surgical interventions.
METHODS: 8 patients with mTEF underwent closure surgery using atrial/ventricular septal defect (ASD/VSD) septal occluders at the Respiratory Department of HuBei Yichang Central People\'s Hospital from 2021 to 2023. The procedure involved percutaneous placement of the occluder through the fistula to achieve closure.
RESULTS: The placement of the cardiac septal occluder was successfully achieved with ease and efficiency in all patients. The study demonstrated that the use of cardiac septal occluder therapy in patients with mTEF can alleviate symptoms, improve quality of life, and enhance survival rates, with no significant complications observed. Furthermore, the study provided comprehensive details on surgical indications, preoperative evaluation and diagnosis, selection of occluder, methods of occlusion, and postoperative care.
CONCLUSIONS: The application of cardiac septal occluder in the treatment of mTEF is a safe and effective palliative treatment. This approach may be particularly beneficial for patients with a high risk of complications and mortality associated with traditional surgical interventions.
摘要：
背景：气管食管瘘（TEF）尤其是恶性TEF（mTEF）是一种罕见但危重的医学疾病，需要立即干预。这种危及生命的状况通常表现在重症患者中，这些患者依赖于长时间的机械通气，并且由于健康状况受损而不适合进行开胸手术。这些mTEF患者的管理仍然是一个重大挑战。本研究旨在评估使用心脏间隔封堵器闭合mTEF的安全性和有效性。
方法：于2021-2023年在湖北省宜昌市中心人民医院呼吸科行房间隔缺损(ASD/VSD)房间隔封堵器封堵术治疗8例mTEF患者。该过程涉及通过瘘管经皮放置封堵器以实现闭合。
结果：在所有患者中，心脏间隔封堵器的放置均成功且有效。研究表明，使用心脏间隔封堵器治疗mTEF患者可以缓解症状，提高生活质量,提高生存率，无明显并发症。此外，这项研究提供了关于手术适应症的全面细节，术前评估和诊断，封堵器的选择，遮挡的方法，和术后护理。
结论：应用心脏间隔封堵器治疗mTEF是一种安全有效的姑息性治疗方法。这种方法对于具有与传统手术干预相关的并发症和死亡率高风险的患者可能特别有益。
方法：于2021-2023年在湖北省宜昌市中心人民医院呼吸科行房间隔缺损(ASD/VSD)房间隔封堵器封堵术治疗8例mTEF患者。该过程涉及通过瘘管经皮放置封堵器以实现闭合。
结果：在所有患者中，心脏间隔封堵器的放置均成功且有效。研究表明，使用心脏间隔封堵器治疗mTEF患者可以缓解症状，提高生活质量,提高生存率，无明显并发症。此外，这项研究提供了关于手术适应症的全面细节，术前评估和诊断，封堵器的选择，遮挡的方法，和术后护理。
结论：应用心脏间隔封堵器治疗mTEF是一种安全有效的姑息性治疗方法。这种方法对于具有与传统手术干预相关的并发症和死亡率高风险的患者可能特别有益。
