我的做法：气管食管穿刺部位的封闭
How I do it: closure of tracheoesophageal puncture site.
作者信息
Hosal S A, Myers E N
机构信息
Department of Otolaryngology, Hacettepe University School of Medicine, Ankara, Turkey.
出版信息
Head Neck. 2001 Mar;23(3):214-6. doi: 10.1002/1097-0347(200103)23:3<214::aid-hed1020>3.0.co;2-5.
BACKGROUND
Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, tracheoesophageal fistulas occasionally need to be closed, usually at the request of the patient, because of leakage through an enlarging fistula. We present our technique for closure of tracheoesophageal fistula.
METHODS
An incision is made at the mucocutaneous junction of the stoma from the 9 to the 3-o'clock position. Tracheoesophageal space is dissected down to and beyond the fistula. The tracheoesophageal tract is divided. The esophageal mucosa is closed with inverted sutures. After multiple layer closure of the esophageal fistula, the tracheal mucosa is closed with everted sutures.
RESULTS
This technique has been used in nine patients. Eight were successful. The remaining patient had radiation therapy failure.
CONCLUSION
This method of closure is simple and effective for those patients who require permanent closure of the tracheoesophageal fistula.
背景
气管食管发音假体在全喉切除术后提供语音方面非常有效。尽管这是一种安全的方法，但气管食管瘘偶尔需要闭合，通常是应患者要求，因为瘘口扩大导致漏气。我们介绍我们闭合气管食管瘘的技术。
方法
在造口的黏膜皮肤交界处从9点至3点位置做切口。将气管食管间隙向下解剖至瘘口并超过瘘口。切断气管食管通道。用内翻缝合法闭合食管黏膜。食管瘘多层闭合后，用外翻缝合法闭合气管黏膜。
结果
该技术已用于9例患者。8例成功。其余患者放疗失败。
结论
对于那些需要永久性闭合气管食管瘘的患者，这种闭合方法简单有效。
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