背景:胃支气管瘘很少见,但危及生命,食管切除术的并发症。它们是由吻合口漏引起的,主要发生在吻合部位周围。在本论文中,我们报道了一例罕见的食管癌食管癌切除术后胃管钉线渗漏的病例,使用肋间肌皮瓣和肺切除术成功治疗。
方法:一名61岁男性因食管癌行食管次全切除术伴区域淋巴结清扫术。术后11天沿着胃管钉线缝合失败,影像学检查还发现了肺脓肿。保守治疗后脓肿未愈合;因此,右下肺叶切除术,胃支气管瘘切除术,初级闭合,首次手术后9个月,用肋间肌瓣修补胃管的渗漏部分。病人的术后过程是顺利的,他在第354天出院了.
结论:我们经历了一例由胃管钉线渗漏引起的胃支气管瘘,并通过右下叶切除术和用肋间肌皮瓣修补渗漏成功治疗。
BACKGROUND: Gastrobronchial fistulas are rare, but life-threatening, complications of esophagectomy. They are caused by anastomotic leakage and mainly occur around anastomotic sites. In the present paper, we report a rare case of leakage from the staple line of a gastric tube after esophagectomy for esophageal cancer, which was successfully treated using an intercostal muscle flap and lung resection.
METHODS: A 61-year-old male underwent subtotal esophagectomy with regional lymphadenectomy for esophageal cancer. The sutures along the staple line of the gastric tube failed 11 days after surgery, and a pulmonary abscess was also found on imaging. The abscess did not heal after conservative treatment; therefore, right lower lobectomy, gastrobronchial fistula resection, primary closure, and patching of the leaking portion of the gastric tube with an intercostal muscle flap were performed 9 months after the first operation. The patient\'s postoperative course was uneventful, and he was discharged on the 354th day.
CONCLUSIONS: We experienced a case involving a gastrobronchial fistula caused by leakage from the staple line of a gastric tube and successfully treated it by performing right lower lobectomy and patching the leak with an intercostal muscle flap.