Suppr超能文献

特发性喉气管狭窄:喉气管切除术的有效确定性治疗

Idiopathic laryngotracheal stenosis: effective definitive treatment with laryngotracheal resection.

作者信息

Ashiku Simon K, Kuzucu Akin, Grillo Hermes C, Wright Cameron D, Wain John C, Lo Bruce, Mathisen Douglas J

机构信息

Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA 02214, USA.

出版信息

J Thorac Cardiovasc Surg. 2004 Jan;127(1):99-107. doi: 10.1016/j.jtcvs.2002.11.001.

Abstract

OBJECTIVE

Little was known about idiopathic laryngotracheal stenosis when it was first described. We have operated on 73 patients with idiopathic laryngotracheal stenosis, have confirmed its mode of presentation and response to surgical therapy, and have established long-term follow-up.

METHODS

Charts of 73 patients treated surgically for idiopathic laryngotracheal stenosis between 1971 and 2002 were retrospectively reviewed.

RESULTS

All patients were treated with a single-staged laryngotracheal resection, with (36/73) and without (37/73) a posterior membranous tracheal wall flap. Nearly all were women (71/73), with a mean age of 46 years (range, 13-74 years). Twenty-eight (38%) of 73 had undergone a previous procedure with laser, dilation, tracheostomy, T-tube, or laryngotracheal operations. After laryngotracheal resection, the majority of patients (67/73) were extubated in the operating room, and 7 required temporary tracheostomies, only 1 of whom was among the last 30 patients. All were successfully decannulated. There was no perioperative mortality. Principal morbidity was alteration of voice quality, which was mild and tended to improve with time. Sixty-seven (91%) of 73 patients had good to excellent long-term results with voice and breathing quality and do not require further intervention for their idiopathic laryngotracheal stenosis.

CONCLUSION

Idiopathic laryngotracheal stenosis is an entity that occurs almost exclusively in women and is without a known cause. It is not a progressive process, but the timing of the operation is crucial. Single-staged laryngotracheal resection is successful in restoring the airway while preserving voice quality in more than 90% of patients. Protective tracheostomy is now rarely required (1/30). Long-term follow-up shows a stable airway and improvement in voice quality.

摘要

目的

特发性喉气管狭窄首次被描述时,人们对其了解甚少。我们已对73例特发性喉气管狭窄患者进行了手术,证实了其临床表现及对手术治疗的反应,并建立了长期随访。

方法

回顾性分析1971年至2002年间接受手术治疗的73例特发性喉气管狭窄患者的病历。

结果

所有患者均接受了一期喉气管切除术,其中36例(73例中的)使用了后膜性气管壁瓣,37例未使用。几乎所有患者为女性(73例中的71例),平均年龄46岁(范围13 - 74岁)。73例中有28例(38%)曾接受过激光、扩张、气管切开、T形管或喉气管手术。喉气管切除术后,大多数患者(73例中的67例)在手术室拔管,7例需要临时气管切开,其中仅1例在最后30例患者中。所有患者均成功拔管。无围手术期死亡。主要并发症是音质改变,程度较轻且随时间有改善趋势。73例患者中有67例(91%)在声音和呼吸质量方面获得了良好至极佳的长期效果,其特发性喉气管狭窄无需进一步干预。

结论

特发性喉气管狭窄几乎仅发生于女性,病因不明。它不是一个进行性过程,但手术时机至关重要。一期喉气管切除术在恢复气道的同时能保留90%以上患者的音质。现在很少需要保护性气管切开(30例中的1例)。长期随访显示气道稳定且音质改善。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验