Background Thoracogastric airway fistula (TGAF) is a fatal complication after esophagectomy. Without active treatment, patients may die of intractable pneumonia, sepsis, massive hemoptysis, or respiratory failure. We determined the clinical value of the two-tube method that involves the precise interventional placement of the nasojejunal tube (NJT) and nasogastric tube (NGT) for TGAF.

Methods Clinical data of patients with TGAF who had undergone fluoroscopic interventional placement of NJT and NGT were analyzed retrospectively. The paired t-test was used to compare the index values before and after treatment. Statistical significance was set at p < 0.05.

Results In total, 212 patients (177 male and 35 female; mean age, 61.3 ± 7.9 years [47–73]) with TGAF who had undergone the two-tube method were included. Posttreatment chest spiral computed tomography and inflammatory indicators showed significantly improved pulmonary inflammation compared with that before treatment. The patients' general condition remained stable. Of 212 patients, 12 (5.7%) underwent surgical repair, 108 (50.9%) received placement of airway stents, and 92 (43.4%) cases only continued treatment with the two-tube method owing to patients' conditions. In total, 47.8% (44/92) patients died of secondary pulmonary infection, bleeding, and primary tumor progression, whereas 52.2% (48/92) patients survived with both tubes.

Conclusion The two-tube method, which involves the precise interventional placement of the NJT and NGT, is simple, safe, and effective for treating TGAF. This method is a bridge for successive treatments or a treatment itself for patients who are unsuitable for surgical repair or stent placement.

背景 胸胃气道瘘（TGAF）是食管切除术后的致命并发症。如果不积极治疗，患者可能会死于顽固性肺炎、败血症、大咯血或呼吸衰竭。我们确定了双管法的临床价值，该法涉及鼻空肠管（NJT）和鼻胃管（NGT）的精确介入放置用于TGAF。

方法 回顾性分析接受透视介入NJT和NGT的TGAF患者的临床资料。采用配对t检验比较治疗前后各指标值。统计显着性设定为p  < 0.05。

结果 总共纳入了 212 名接受两管法的 TGAF 患者（177 名男性和 35 名女性；平均年龄，61.3 ± 7.9 岁 [47-73]）。治疗后胸部螺旋CT和炎症指标显示肺部炎症较治疗前明显改善。患者一般情况保持稳定。212例患者中，12例（5.7%）接受了手术修复，108例（50.9%）接受了气道支架置入术，92例（43.4%）因患者情况仅继续采用两管法治疗。总共有 47.8% (44/92) 的患者死于继发性肺部感染、出血和原发性肿瘤进展，而 52.2% (48/92) 的患者在使用双管时存活。

结论 NJT和NGT精准介入的两管法治疗TGAF简单、安全、有效。对于不适合手术修复或支架置入的患者，该方法是连续治疗的桥梁或治疗本身。