JPH0321226Y2 - - Google Patents

Description

[Detailed description of the device] [Field of industrial application] The present device is useful for cases of anastomotic recurrence after total gastrectomy for gastric cancer, or cases of esophageal obstruction or narrowing due to non-surgical cases of esophageal cancer or cardia cancer. This invention relates to an intraesophageal indwelling tube intended to contribute to oral nutritional administration, treatment of cicatricial stenosis occurring after esophageal cancer resection, and oral nutritional administration.

[Prior art]

In cases where transendoscopic incision enlargement or esophageal bougie enlargement has been performed in recent years to improve passage obstruction for scars after total gastrectomy or esophagectomy for cancer, or narrowing of the anastomosis due to cancer recurrence. are becoming more common.

Examples of devices that use an esophageal insertion tube for this purpose include
As described in the publication, after enlarging the narrowed area with an esophageal bougie, the esophageal insertion tube is placed on the guide wire as a cloak, and the clip at the tip of the esophageal insertion tube is tied with a piano wire slightly protruding from the tip of the guide wire to close the occluded area. There is a technique in which the piano wire and clip are removed and then placed in place.
Not only did the shape of the esophageal insertion tube become complicated, but there were also cases where the clip of the esophageal insertion tube could not be removed as easily as the piano wire. Furthermore, since the guide wire used as an insertion tool is weak, there is a high risk of cancer perforation in the esophageal insertion tube, and there is a drawback that skill is required for insertion and placement.

Therefore, the inventors of the present invention first developed an endoesophageal intubation device that solved these problems, and filed a patent application for
Disclosed in No. 140570. This consists of an esophageal intubation tube 11, a pushing tube 12, and an esophageal bougie 13, as shown in FIG.
Its usage is as follows: First, use the esophageal bougie 13 to open and enlarge the narrowed or obstructed part of the esophagus, and then insert the esophageal intubation tube 11 as a mantle into the distal end of the esophageal bougie 13, and attach the pushing tube 12. Then, the esophageal intubation tube 11 is inserted into the esophagus while pressing the socket 14 of the esophageal intubation tube 11 with the pushing tube 12 and left in place.

Conventional intraesophageal indwelling tubes used in these surgical procedures generally have a cup-shaped or funnel-shaped upper end, a cylindrical middle part, and a rib 16 or projection as shown in Figure 4 at the lower end. It has 17. With this shape, the upper end part hangs over the upper part of the constriction part to prevent it from falling, and the lower end part hangs on the lower part of the constriction part to prevent it from floating up, so that it can be fixedly placed in a predetermined constriction part. On the other hand, since the lower end of these tubes is convex outward, there is a lot of resistance at the narrow part during insertion, and the lower end may get in the way when the tube is retrieved for some reason after the tube has been placed. This causes friction, which causes many problems both during insertion and during retrieval. In addition, in order to make the tube easier to collect, there are some tubes on the market that are designed so that the protrusion on the outer circumference of the lower end is turned inside out when the tube is recovered, but the protrusion extends all the way around the lower end. The resistance during retrieval was quite high, and there was still a risk of damaging the esophageal tissue.

[Purpose of invention]

In view of the current situation, the present invention has developed an esophageal indwelling tube that can be easily inserted and placed into the narrowed part of the esophagus, and that can minimize damage to the tissues in the esophagus when retrieving it. The aim is to provide an internally indwelling tube, and its purpose is to administer oral nutrition when the esophagus is blocked or narrowed due to cancer, etc., and to treat scarring and narrowing that occurs after removal of esophageal cancer, and to administer oral nutrition. It is to contribute to etc.

[Structure of the idea]

That is, the present invention is an intraesophageal indwelling tube having a cup-shaped or funnel-shaped socket at the upper end, and one end of a plurality of petal-shaped wings is fixed on the outer periphery of the lower end. This intraesophageal indwelling tube is characterized in that the other end of the petal-shaped wings is a free end extending toward the receptacle side of the upper end of the tube, and is formed to be able to be turned over.

Hereinafter, the embodiment will be described in detail with reference to the drawings.

FIG. 1 is a diagram showing the overall structure of an intraesophageal indwelling tube according to an embodiment of the present invention. The esophageal indwelling tube of the present invention corresponds to the esophageal intubation tube 11 of the esophageal intubation device shown in FIG. 3, and the tube body 1 has a cup-shaped socket 2 at the upper end. However, the middle part 3 has a cylindrical shape, and the lower end part has a plurality of petal-shaped floating prevention wings 4 on the outer periphery.

The cup-shaped receptacle 2 at the upper end serves as a receptacle for the pushing end of the pushing tube to prevent it from falling out in the esophagus, a receptacle for the pushing end of the pushing tube when it is pushed into the esophagus, and a receptacle for food during indwelling. 10m/m
It is 30m/m to 30m/m. If the outer diameter is less than 10 m/m, there is little hope of preventing it from falling off, and if the outer diameter is 30 m/m or less,
This is because if it exceeds m/m, it becomes impossible to insert it into the esophagus. Further, it is preferable that the edge of the cup-shaped socket 2 be thinner than other parts. The edge is the part that contacts the esophagus, and if it is thick, the esophageal tissue is likely to undergo compression necrosis.

For the intermediate part 3 that covers the narrowed part, it is better for the inner diameter to be as thick as possible from a functional standpoint, and for easier insertion, the outer diameter is better to be thinner. Although there are individual differences, the inner diameter is generally 5 to 14 m/mφ and the outer diameter is 10 to 20 m/mφ, preferably the inner diameter is 9 to 12 m/mφ and the outer diameter is 10 to 13 mφ.
It is preferable to set it to m/mφ. This is because if the inner diameter is less than 5 m/mφ, it will be difficult for food to pass through, and if the outer diameter is more than 20 m/mφ, it will be difficult to insert it into the esophagus.

The tube body 1 is made of rubber such as natural rubber, isoprene rubber, silicone rubber, or flexible plastic, and its wall thickness is 0.5 to 2.
m/m, and if it is thin, there is no problem in reinforcing it with spiral stainless steel wire, fibers, etc. It goes without saying that it is preferable to contain an X-ray contrast agent such as bismuth dicarbonate or barium sulfate.

The petal-shaped floating prevention wing 4 at the lower end has one end fixed to the lower end of the tube body 1, and the other end is a free end extending toward the receiving port 2 side at the upper end of the tube body. This serves to prevent the tube placed in the esophagus from falling off (floating) toward the mouth, and since multiple tubes are placed intermittently around the periphery, it is more effective than a tube that has protrusions all around the circumference. It has much less resistance and is easy to insert. In addition, since the shape is petal-like, it fits well at the narrow lower end and can effectively perform the function of preventing floating. The number of anti-float wings 4 is not particularly limited, but is preferably 2 to 8. Furthermore, in the unlikely event that a problem occurs and the tube is to be retrieved from the esophagus, it is pulled up from the oral side in the direction of arrow A in Figure 2. The wing 4 is turned inside out as shown in FIG. 2, and the resistance becomes extremely small, so it can be easily recovered. Further, since the anti-floating wing 4 of the present invention does not extend all the way around the lower end, it can be easily turned over with a small force, and therefore damage to the esophageal tissue during retrieval can be kept to a minimum. The material constituting the anti-floating wing 4 may be the same as that of the tube body 1, but there is no problem with using a different material, and the thickness will vary depending on the material, but rubber or flexible plastic may be used. When used, 0.5 to 2 m/m is suitable.

[Effect of idea]

As described above, the intraesophageal indwelling tube according to the present invention can be easily inserted and left in the esophagus, fits appropriately into the narrowed part of the esophagus, and even if it becomes necessary to retrieve the esophagus, the tube can be easily inserted and left in the esophagus. Because it can be easily retrieved without damaging tissue, it is recommended for patients with esophageal obstruction or narrowing.
Esophageal intubation can be performed more easily and effectively, and by placing this tube in place, the patient can eat orally, which is extremely useful medically.

[Brief explanation of the drawing]

FIG. 1 is a diagram showing the overall structure of an intraesophageal indwelling tube according to an embodiment of the present invention, in which a is a side view and b is a front view seen from the lower end. Figure 2 shows the steps taken when retrieving the intraesophageal tube placed in the narrowed area.
FIG. 6 is a diagram showing a state in which the anti-float wing is turned inside out. Furthermore, Fig. 3 is a sectional view showing an esophageal intubation tool for inserting and indwelling the esophageal indwelling tube of the present invention into the esophagus, and Fig. 4 is a schematic diagram showing an example of a conventional esophageal indwelling tube. It is.

Claims (1)

[Scope of utility model registration request] It is an intraesophageal indwelling tube having a cup-shaped or funnel-shaped socket at the upper end, and one end of a plurality of petal-shaped wings is fixed on the outer periphery of the lower end. An intraesophageal indwelling tube characterized in that the other end is a free end extending toward the receptacle side of the upper end of the tube and is reversible.