恶性与非恶性获得性气管食管瘘的治疗策略及疗效比较

Munir Ahmad Baloch, N. Din, Shahida Munir, Shazia Ismail, Nazir Ahmad
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摘要

目的:比较恶性与非恶性获得性气管食管瘘的治疗策略。研究设计:前瞻性研究地点和研究时间:2022年1月1日至2022年12月31日,奎达市博兰医学院教学医院。方法:选取60例气管食管瘘患者。然后将患者分为两组,根据方便的抽样,第一组被命名为恶性,而第二组是非恶性组。记录每位患者的潜在病因,并通过成像和内窥镜技术评估临床情况。对入选病例采用术前、术中及支架置入管理策略。单、双支架植入术是根据具体情况而定。结果:良性气管食管瘘患者平均年龄为10.5±1.2岁,恶性气管食管瘘患者平均年龄为51.2±6.5岁。非恶性气管食管瘘20例,恶性气管食管瘘40例。在这些病例的主要结局中,非恶性病例的术前死亡率高于恶性病例,而恶性病例的发病率要高得多,有35%的患者出现瘘管复发。实际意义:恶性肿瘤似乎是患者TEF的主要原因,他们的生存机会也更少。结论:支架植入术是提高恶性和非恶性患者生存率的最佳治疗策略。关键词:恶性肿瘤,瘘,食道,呼吸机,支架植入术
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Comparison of Malignant and Non-malignant Acquired Tracheoesophageal Fistulae Management Strategies and Outcomes
Aim: To compare the malignant and non-malignant acquired tracheoesophageal fistulae management strategies. Study design: Prospective study Place and duration of study: Bolan Medical College Teaching Hospital, Quetta from 1st January 2022 to 31st December 2022. Methodology: Sixty patients suffering from tracheoesophageal fistulae were enrolled. The patients were then divided into two groups where depending upon convenient sampling the first group was named as malignant while second was non-malignant group. The underlying etiology of each patient was recorded and assessments of clinical conditions were made through imaging and endoscopic techniques. The preoperative, intraoperative and stenting management strategies were applied on the enrolled cases. Single, double stenting was based on case to case. Results: The mean age of the cases with benign tracheoesophageal fistula was 10.5±1.2 years while those having malignant tracheoesophageal fistula was 51.2±6.5 years. There were total 20 cases of tracheoesophageal fistula with nonmalignant diagnosis while 40 cases with malignant tracheoesophageal fistula. Within the primary outcomes of the cases the preoperative mortality was higher in non-malignant cases than malignant while morbidity was much higher in the malignant cases with 35% in that presenting fistula recurrence. Practical Implication: Malignancy appeared to be the main cause of TEF in patients and their survival chances are also less. Conclusion: Stenting is best managing strategy in patients with improved survival rate malignant as well as non-malignant cases. Keywords: Malignancy, Fistula, Esophagus, Ventilator, Stenting
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