人工食道が有効であった食道癌術後縫合不全の1症例

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  • SUCCESSFUL TREATMENT OF LEAKAGE FOLLOWING ESOPHAGECTOMY FOR AN ESOPHAGEAL CANCER BY INTUBATING A FLEXIBLE TUBE -REPORT OF A CASE-

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A recent advance in the surgical treatment for esophageal cancer reduces the incidence of the leakage at the anasomotic site after esophagectomy. But the leakage is still an important problem when the severe complication such as pyothorax is assosiated. In this report, we describe a successful treatment of anasomotic leakage following esophagectomy by intubating a flexible tube as a conservative therapy.<br> A 53-year-old male paient was subtotally esophagectamized for a thoracic esophageal cancer and was reconstructed by a gastric tube under right thoracotomy. The route of the reconstruction was the retromediastinum. The leakage at the anastomotic site was found 10 days after the surgery, and subsequently right pyothorax occurred. Immediately, the thoracic drainage was performed as a first aid and intravenous hyper-alimentation was carried out. However, those treatment were ineffective. We used a flexible tube to prevent saliva spreading at the fistula. After intubation of a tube, pyothorax improved and the fistula was finally closed. Originally, the intubation method for esophageal cancer had been developed to provide for improvement of QOL of the patients with severe stenosis or esophago-bronchial fistula. We experienced in the present care, a flexible tube intubation was also useful to close the leakage at the anastomotic site and to treat pyothorax in esophagectomy.

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