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学科主题: 临床医学
题名:
Reliable management of post-esophagectomy anastomotic fistula with endoscopic trans-fistula negative pressure drainage
作者: Liu, Yi-Nan1; Yan, Yan2; Li, Shi-Jie2; Liu, Hui3; Wu, Qi2; Zhang, Li-Jian1; Yang, Yue1; Chen, Jin-Feng1
关键词: anastomotic fistula ; esophagectomy ; endoscopic management
刊名: WORLD JOURNAL OF SURGICAL ONCOLOGY
发表日期: 2014-07-30
DOI: 10.1186/1477-7819-12-240
卷: 12
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Oncology ; Surgery
研究领域[WOS]: Oncology ; Surgery
关键词[WOS]: TRANSHIATAL ESOPHAGECTOMY ; CLINICAL-EXPERIENCE ; LEAKS ; REFINEMENTS
英文摘要:

Background: A gastroesophageal anastomotic fistula remains a potentially life-threatening post-esophagectomy complication. To promote fistula closure, we developed a modified endoscopic method of trans-fistula drainage with persistent negative pressure. In this study, we aimed to evaluate the efficacy of this endoscopic therapy.

Methods: Between June and November 2013, five male patients with post-surgical esophageal leakages who had undergone trans-fistula drainage therapy were treated with the modified endoscopic trans-fistula negative pressure drainage (E-TNPD) method. We placed a nasogastric silicone tube into the paraesophageal cavity through the fistula and accomplished drainage of the infected effusion with continuous negative pressure, resulting in shrinkage of the para-anastomotic cavity and eventual fistula closure. We withdrew the trans-fistula drainage when there were no signs of leakage, as confirmed by esophagography. Final closure was confirmed by esophagography before the patient was allowed to begin oral intake.

Results: E-TNPD was successful in all five patients. The median duration of drainage until tube removal was 34 days (range: 18 to 81 days). The duration for Cases 1 to 4 was 18 to 28 days. Case 5 suffered from multiple separate leaks at the anastomotic site and the gastric conduit. Complete restoration was achieved in 81 days for this patient. We found that in general, the earlier that trans-fistula drainage was established, the shorter the duration of hospitalization until complete defect closure.

Conclusions: E-TNPD provided reliable and convenient management of post-surgical gastroesophageal anastomotic fistula and esophageal perforation. This method promoted fistula closure and prevented unnecessary repeated endoscopic examinations, extra equipment and expense.

语种: 英语
所属项目编号: Z11111005450000 ; 81101598
项目资助者: Beijing Science New Star Plan ; National Nature Science Foundation of China
WOS记录号: WOS:000339837000001
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55132
Appears in Collections:北京大学临床肿瘤学院_胸外科_期刊论文

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作者单位: 1.Peking Univ, Canc Hosp & Inst, Dept Thorac Surg 2, Key Lab Carcinogenesis & Translat Res,Minist Educ, Beijing 100142, Peoples R China
2.Peking Univ, Canc Hosp & Inst, Endoscopy Ctr, Key Lab Carcinogenesis & Translat Res,Minist Educ, Beijing 100142, Peoples R China
3.Beijing Pharma & Biotech Ctr, Beijing 100193, Peoples R China

Recommended Citation:
Liu, Yi-Nan,Yan, Yan,Li, Shi-Jie,et al. Reliable management of post-esophagectomy anastomotic fistula with endoscopic trans-fistula negative pressure drainage[J]. WORLD JOURNAL OF SURGICAL ONCOLOGY,2014,12.
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