胸管移入氣管或食道的處理

Management of Chest Tube Migration Into the Trachea or Esophagus

胸腔引流造成胸管意外移入氣管或食道是罕見。在此，我們報告兩位病人，各有不同的際遇。第一位病人因右側開胸手術，切除延遲診斷穿孔的食道，胸管穿過不健康的右主支氣管到遠端氣管。另一位病人因食道失弛症，接受胸腔鏡食道部份肌肉切除術後，發生了胸管移入食道的事件。這兩名病人，我們使用逐步把胸管往外拔，成功解決這兩起罕見意外事件。根據我們的經驗，當胸管意外移入氣管或食道時，在考慮積極手術之前，可以使用逐步拔管的替代方案。

Accidental migration of a chest tube into the trachea or esophagus during pleural drainage is rare. We report two patients with distinct events. In the first case, a chest tube penetrated the unhealthy right main bronchus, extending into the distal trachea following a right thoracotomy for resecting a recently diagnosed perforating esophagus. The second patient experienced chest tube migration into the esophagus after thoracoscopic esophagomyotomy for esophageal achalasia. In both cases, we successfully managed these rare events by employing a step-by-step tube withdrawal approach. Our experiences suggest that, when faced with the accidental migration of a chest tube into the trachea or esophagus, the alternative option of step-by-step tube withdrawal could be considered before opting for aggressive surgical intervention.