The experience of surgical methods without repairing the fistula for 92 cases with gastrointestinal intrathoracic fistula
10.3760/cma.j.cn112434-20220317-00080
- VernacularTitle:不修补瘘口手术方法治疗92例消化道胸内瘘的经验
- Author:
Guangyu YANG
1
;
Lei XIAN
;
Chusheng HUANG
;
Zhen LIU
;
Xiang CHEN
;
Wen ZHAO
;
Gaoxiang WEI
;
Xiangsen LIANG
;
Yu SUN
;
Shengzhuang YANG
;
Wenzhou LIU
;
Xiaohan BI
;
Feihai LIANG
;
Menghuan WANG
;
Hailong DENG
;
Yourong CHEN
;
Yifei LU
;
Gaofei ZHAI
Author Information
1. 广西医科大学第二附属医院胸心血管外科，南宁 530000
- Keywords:
Gastrointestinal intrathoracic fistula;
Esophagogastric anastomotic fistula;
Esophageal perforation;
Esophageal rupture;
Without repairing the fistula
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2022;38(12):742-745
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the experience of surgical methods without repairing the fistula for 92 cases with gastrointestinal intrathoracic fistula.Methods:The surgical methods without repairing the fistula were performed through VATS, small incision assisted with VATS or thoracotomy. The focus of the surgery was to promote lung expansion, eliminate the residual cavity of chest cavity and keep effective drainage. After entering the chest cavity from the affected side, wash chest cavity with a large amount of warm normal saline and sterilize intermittently with iodophor to ensure the sterile environment in the pus cavity. Then completely remove the pleural cellulose or fiberboard on visceral pleura to promote lung expansion, eliminate the residual cavity of the chest cavity. The fistula was covered tightly and supported firmly by the visceral pleura on the lung. Multiple T-tubes were placed in thoracic cavity and fistula to keep effective postoperative drainage.Results:Among 92 cases, 85 cases were cured and the cure rate was 92.4% (85/92).7 cases died and the mortality rate was 7.61% (7/92). The 7 dead cases include 5 cases with esophagogastric anastomotic fistula (the death of 3 cases was cause by aortic esophagogastric fistula, the death of 1 case was cause by thoracic gastric tracheal fistula and 1 case was dead because of pulmonary infection and respiratory failure), 1 case with esophageal rupture (the cause of death was septic shock ), and 1 case with esophageal perforation(the cause of death was pulmonary infection and respiratory failure).Conclusion:Most of the surgeries without repairing gastrointestinal intrathoracic fistula are conducted simply through VATS or small incision assisted with VATS., which is safe and effective.
