ABSTRACT
Tracheoesophageal fistula is a rare disease of abnormal communication between esopha- gus and respiratory system. The common causes are the acquired origins in adult such as trauma, infection of the adjacent organs, malignant tumor, and foreign body. Among the traumatic origins, chemical drug, the procedure of the dilatation on the stenotic area, blunt trauma(fall, collisions), penetrating trauma(bullet, knife), and pressure injury are much more common than others. Recently, trauma and foreign body in the esophagus and bronchus are becoming the main cause of the tracheoesophageal fistula, however the frequency of the development of tracheoesophageal fistula caused by the infectious diseases is getting decreased. Fibrinogen-thrombin glue stimulates the healing process of the wound and the ulcer. We treated a 52-year-old male patient with nan-inalignant tracheoesophageal fistula, who had symtoms of pharyngolaryngeal and chest discomfort concomitant with a paroxysmal cough on swallowing food which were caused by fish bone. The diagnosis of tracheoesophageal fistula was made by the esophagogram, chest CT, and esop aecopy. By using the therapeutic endoscopy with an injection of the fibrinogen-glue, the tracheoesopeal fistula was obliterated completely with dramatic symptomatic improvement. Here we conqluded that this method would be the one of the best methods for the treatment of tracheoesophageal fistula.
Subject(s)
Adult , Humans , Male , Middle Aged , Adhesives , Bronchi , Communicable Diseases , Cough , Deglutition , Diagnosis , Dilatation , Endoscopy , Esophagus , Fibrinogen , Fistula , Foreign Bodies , Intestines , Rare Diseases , Respiratory System , Stomach , Thorax , Thrombin , Tomography, X-Ray Computed , Tracheoesophageal Fistula , Ulcer , Wounds and InjuriesABSTRACT
Anastomosis of rat common carotid artery was performed by applying four crossed-fixing sutures and by mantling with human fibrinogen-thrombin glue. There was a 97% patency rate 24 hours after surgery, and the anastomosed vessels were still patent on the 7th and 30th postoperative days. Aneurysm formation was absent but stenotic change was seen to 1 case of 8 angiographic studies. Histopathological studies of microvascular anastomosis showed that this surgical technique of anastomosis has certain advantages, namely that it reduces the number of sutures needed, is less traumatic to the vascular wall, ensures elastic vascular junction, and the glue used possess high biological inertness that provides a better physiological connection of vessels than conventional suturing. The duration of the clipping and the operation is significantly reduced. A tensile strength test 24 hours following operation and 1 week later showed that this anastomosis was significantly better than that achieved with the usual manual suture method. The author therefore concludes that this new surgical technique of microvascular anastomosis may be valuable in microvascular neurosurgery.