Gonzálvez Piñera J, Claret Corominas I, Mayol Gómez J, Sala Castellví P, Sagrera Felip X, Vila Ceren C, Demestre Guasch X, Raspall Torrent F
Complejo Hospitalario Universitario de Albacete, Hospital de Barcelona-SCIAS.
Cir Pediatr. 2000 Apr;13(2):58-61.
Acquired tracheal stenosis in children can be either to direct cervicothoracic trauma or to post-intubation. Resection and end-to-end anastomosis continues to be the treatment of choice. The high rate of restenosis is directly related to anastomotic tension in resections of more than 2 cm. We report a case of a 7 year old child who suffered severe injury caused by car crash and intubation at the scene of the accident, with subsequent development of a cervical tracheal stenosis which required preoperative iterative laser sessions and balloon dilatation on 3 occasions, without result. Resection and primary anastomosis with an external stent of ePTFE was performed. The patient was treated successfully and was extubated promptly. Post-operative endoscopic studies and magnetic resonance imaging showed widely patent tracheal lumina with no stenosis. Three years post-operatively, the child is asymptomatic and participates in competitive sport activities. We can conclude that the model described above was clinically effective in the prevention of post-anastomotic tracheal stenosis in the child.
儿童获得性气管狭窄可由颈胸直接创伤或插管后引起。切除并端端吻合仍是首选治疗方法。在超过2厘米的切除术中，再狭窄率高与吻合口张力直接相关。我们报告一例7岁儿童，在车祸现场受重伤并接受插管，随后发生颈段气管狭窄，术前需要进行3次反复激光治疗和球囊扩张，但均无效。进行了切除并使用ePTFE外部支架进行一期吻合。患者治疗成功并迅速拔管。术后内镜检查和磁共振成像显示气管腔广泛通畅，无狭窄。术后三年，该儿童无症状，参加竞技体育活动。我们可以得出结论，上述模型在预防儿童吻合口后气管狭窄方面临床效果良好。
