关键词: 食管气管瘘, 食管支气管瘘, 外科治疗

Abstract: Background and purpose: Esophagorespiratory fistula is often accompanied with life-threatening pulmonary infection. Though the pulmonary infection can be controlled temporarily by conservative medical treatment or stent placement, but patients have a poor quality of life and short survival time. This study was to investigate the effectiveness and security of surgical treatment for patients with esophagorespiratory fistula. Methods: We retrospectively analyzed the clinical data of 7 patients with esophagorespiratory fistula after surgical treatment between Jun. 2009 and Oct. 2013 in Henan Province Chest Hospital. The causes were the following: esophageal cancers (4 cases), congenital fistula (1 case), diverticulum (1 case) and trauma (1 case). All patients underwent surgical treatment through thoracotomy. Surgical treatment consisted of esophagectomy gastroesophageal anastomosis and pulmonary lobectomy in 2 patients, esophagectomy gastroesophageal anastomosis and tracheal fistula repair in 1 patient, remnant stomach repair and pulmonary lobectomy in 1 patient, esophageal fistula repair and pulmonary lobectomy in 2 patients and esophagotracheal fistula double deligation in 1 patient. Results: There was no perioperative death. The incidence rate of postoperative complications was 57% (4/7). Two patients got severe pulmonary infection. One patient suffered from esophageal-tracheal fistula recurrence and underwent elective jejunostomy. One patient had thoracic cavity infection. Six patients resumed normal eating after postoperative recovery. Follow-up was acquired in all cases. Three cases with benign fistula remained well without recurrence. Four cases with malignant fistula had an average survival time of 18.8 months (11–28 months). Conclusion: Once congenital esophagorespiratory fistula is confirmed, surgical management is recommended as early as possible. The selective surgical treatment for malignant esophagorespiratory fistulas according to patient’s condition could improve the life quality and lengthen the survival time.

Key words: Esophagotracheal fistula, Esophagobronchial fistula, Surgical treatment