Eliashar Ron, Sichel Jean-Yves, Eliachar Isaac
Department of Otolaryngology-Head and Neck Surgery, The Hebrew University School of Medicine, Hadassah Medical Center, Jerusalem, Israel.
Otolaryngol Head Neck Surg. 2005 Jan;132(1):115-8. doi: 10.1016/j.otohns.2004.08.009.
To delineate a technique that avoids the complications associated with surgical closure of long-term or permanent tracheostomy (LTT). Study design A case series that describes the technique and clinical outcomes.
Thirty-seven of 300 patients with a previously established LTT underwent primary surgical closure of their stoma after their underlying disease had been resolved. The surgical technique combined a turnover flap with medialization of fibroadipose tissue, followed by additional closure with an advancement skin flap.
After a mean follow-up of 3.2 years, no patient developed major complications. Four patients developed minor complications, which responded to conservative treatment. In all patients, the functional results were satisfactory, as were the cosmetic results, with the exception of 1 case. None required re-tracheostomy.
This simple and reliable new surgical technique for closing LTT avoids the potential failures and complications encountered in previously published procedures.
描述一种避免长期或永久性气管造口术（LTT）手术闭合相关并发症的技术。研究设计：描述该技术及临床结果的病例系列。
300例既往已行LTT的患者中，37例在基础疾病解决后接受了造口一期手术闭合。手术技术包括翻转皮瓣联合纤维脂肪组织内移，随后用推进皮瓣进一步闭合。
平均随访3.2年后，无患者发生严重并发症。4例患者出现轻微并发症，经保守治疗后好转。除1例患者外，所有患者的功能结果和美容效果均令人满意。无一例需要再次气管造口术。
这种用于闭合LTT的简单可靠的新手术技术避免了既往已发表手术中可能出现的失败和并发症。
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