目的 分析全覆膜食管支架治疗食管癌术后吻合口瘘的临床价值.方法 2010年3月～2012年10月收治15例食管癌术后食管-胃吻合口瘘患者,其中吻合口-纵隔瘘5例,吻合口-胸膜瘘8例,吻合口-气管瘘2例,在DSA引导下行全覆膜食管支架置入治疗.结果 l5例置入全覆膜食管支架均成功.术后3～4周,取出食管支架12例,3例支架永久性留置,行纤维内镜和上消化道造影均提示瘘口已愈合.15例术后除了有食管异物感、胸痛、胃食管反流外,未发生严重并发症如食管穿孔、大出血等.结论 全覆膜食管支架治疗食管癌术后吻合口瘘是一种简便、安全、有效的方法.%Objective To assess the clinical value of esophageal fully - covered stents in treating the esophageal cancer with anastomotic fistula occurring after esophagectomy. Methods During the period from March 2010 to October 2012, a total of 15 cases having esophageal cancer with anastomotic fistula were admitted to authors' hospital. The disorders included anastomotic-mediastinum fistula (n = 5), anastomotic-pleural fistula (n = 8) and anastomotic - tracheal fistula (n = 2). Under DSA guidance, esophageal fully-covered stent implantation was carried out in all patients. The clinical results were analyzed. Results Esophageal fully - covered stent implantation was successfully accomplished in all 15 patients. The esophageal stent was smoothly retrieved in 12 cases at 3 - 4 weeks after the operation. In three cases the esophageal stent was permanently placed in the esophagus. Esophageal fiberscopic examination and contrast examination showed that the fistula orifice was sealed in all patients. After the operation patients complained of mild esophageal foreign body sensation, chest pain and gastroesophageal reflux, but no serious complications such as esophageal perforation or massive bleeding occurred. Conclusion For the treatment of esophageal cancer with anastomotic fistula occurring after esophagectomy, esophageal fully - covered stent implantation is a simple, safe and effective method.
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