内容紹介
Summary
We report the case of a patient with esophageal cancer accompanied by esophago-bronchial fistula and pneumonia, who experienced improved quality of life following multimodal therapy that included esophageal bypass surgery. A 56-year-old man was diagnosed with advanced esophageal cancer with an esophago-bronchial fistula on computed tomography scan. He underwent esophageal bypass surgery followed by definitive chemoradiotherapy. He started eating 12 days after the surgery and was discharged home after the completion of chemoradiotherapy. On follow-up, the primary lesion was found to be significantly decreased in size and the esophago-bronchial fistula was closed. Although the patient ultimately died owing to distant metastases, he enjoyed a prolonged period of survival following surgery. Multimodal therapy including esophageal bypass surgery is an useful strategy for treating patients with critical conditions such as esophago-bronchial fistula induced by esophageal cancer.
要旨
初診時すでに食道癌による食道気管支瘻・肺炎を有したにもかかわらず,食道バイパス術などの集学的治療により良好なQOLを保つことができた症例を経験したので報告する。症例は56歳,男性。CT検査にて食道気管支瘻を伴った進行食道癌と診断した。食道バイパス手術を先行させ,その後根治的化学放射線療法を施行した。術後12日目より経口摂取を開始し,化学放射線療法終了後に自宅退院となった。治療後,原発巣は著明に縮小し,食道気管支瘻も閉鎖した。最終的に遠隔転移再発で原病死したが,最後まで良好なQOLを保つことができた。食道気道瘻は重篤な病態であるが,食道バイパス術は集学的治療の一環として有用な治療戦略と考えられた。
目次
We report the case of a patient with esophageal cancer accompanied by esophago-bronchial fistula and pneumonia, who experienced improved quality of life following multimodal therapy that included esophageal bypass surgery. A 56-year-old man was diagnosed with advanced esophageal cancer with an esophago-bronchial fistula on computed tomography scan. He underwent esophageal bypass surgery followed by definitive chemoradiotherapy. He started eating 12 days after the surgery and was discharged home after the completion of chemoradiotherapy. On follow-up, the primary lesion was found to be significantly decreased in size and the esophago-bronchial fistula was closed. Although the patient ultimately died owing to distant metastases, he enjoyed a prolonged period of survival following surgery. Multimodal therapy including esophageal bypass surgery is an useful strategy for treating patients with critical conditions such as esophago-bronchial fistula induced by esophageal cancer.
要旨
初診時すでに食道癌による食道気管支瘻・肺炎を有したにもかかわらず,食道バイパス術などの集学的治療により良好なQOLを保つことができた症例を経験したので報告する。症例は56歳,男性。CT検査にて食道気管支瘻を伴った進行食道癌と診断した。食道バイパス手術を先行させ,その後根治的化学放射線療法を施行した。術後12日目より経口摂取を開始し,化学放射線療法終了後に自宅退院となった。治療後,原発巣は著明に縮小し,食道気管支瘻も閉鎖した。最終的に遠隔転移再発で原病死したが,最後まで良好なQOLを保つことができた。食道気道瘻は重篤な病態であるが,食道バイパス術は集学的治療の一環として有用な治療戦略と考えられた。