Bisson A, Bonnette P, el Kadi N B, Leroy M, Colchen A, Personne C, Toty L, Herzog P
Department of Thoracic Surgery, Centre Médico-Chirurgical Foch, Suresnes, France.
J Thorac Cardiovasc Surg. 1992 Oct;104(4):882-7.
Since 1975 200 tracheal sleeve resections for iatrogenic tracheal and subglottic laryngeal stenoses have been performed in our institution. Preoperative Nd:YAG laser is of paramount help in opening the stenoses. Tracheography is usually performed to specify the length of the stenosis and the distance from the vocal cords. Operative procedures are described. One hundred seventy five (87.5%) patients are definitely cured, but in this group 16 patients required a Montgomery tube for 6 months to 1 year to recover a normal tracheal diameter. Two patients needed a second tracheal sleeve resection. Nine (4.5%) patients died, and 16 (8%) had recurrent stenoses. Stenoses in these patients were treated with use of a tracheostomy tube, a permanent Montgomery tube, or an endotracheal stent. Partial anterior cricoid resections performed in 21 patients have had the same results as those of the whole series. Twenty one laryngeal releases were performed and proved to be efficient and safe. In our experience complications can be avoided by good selection and preparation of the patients, accurate identification of the level and length of the stenosis, and meticulous technique.
自1975年以来，我们机构已对200例医源性气管及声门下喉狭窄患者实施了气管袖状切除术。术前钕钇铝石榴石激光对于打开狭窄至关重要。通常进行气管造影以明确狭窄的长度以及与声带的距离。文中描述了手术步骤。175例（87.5%）患者获得确切治愈，但在该组中，16例患者需要放置蒙哥马利管6个月至1年，以使气管直径恢复正常。2例患者需要再次进行气管袖状切除术。9例（4.5%）患者死亡，16例（8%）出现复发性狭窄。这些患者的狭窄采用气管造口管、永久性蒙哥马利管或气管内支架进行治疗。21例患者接受的部分环状软骨前部切除术与整个系列的结果相同。实施了21例喉松解术，结果证明有效且安全。根据我们的经验，通过对患者进行良好的选择和准备、准确识别狭窄的部位和长度以及采用精细的技术，可以避免并发症的发生。
