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[节段性气管切除术治疗气管狭窄]

[Segmental tracheal resection for the treatment of tracheal stenoses].

作者信息

Weidenbecher M, Weidenbecher M, Iro H

机构信息

Klinik mit Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universität, 91054, Erlangen.

出版信息

HNO. 2007 Jan;55(1):21-8. doi: 10.1007/s00106-006-1392-9.

Abstract

BACKGROUND

Segmental tracheal resection is considered to be the standard treatment of tracheal stenoses.

MATERIALS/METHODS: During the time period 1985-2002, segmental tracheal resection with a primary end-to-end anastomosis was performed in 117 patients with a cervical or upper thoracal stenosis of the trachea. The age distribution of the patients was between 7 and 77 years. Of the patients with a benign tracheal stenosis, sufficient data for a retrospective analysis were available in 101 patients. The length of the resected tracheal segments varied between 2 and 6 cm which required mobilisation of the trachea and the larynx and, if necessary, incision of the pulmonary ligament.

RESULTS

In 5 patients a permanent damage of the recurrent laryngeal nerve was seen, of which 4 had undergone revision surgery and 10 months after surgery 93% presented with a large and stable tracheal lumen without any relevant restenosis. Due to a restenosis of 70-80% causing dyspnea at rest, 3% of the 101 patients had to undergo revision surgery. In 4% a mild and asymptomatic restenosis of 30-40% was seen which did not require any further treatment.

CONCLUSION

These results demonstrate that segmental tracheal resection can safely and effectively remove stenotic tracheal segments of up to 6 cm and is therefore the treatment of choice.

摘要

背景

节段性气管切除术被认为是气管狭窄的标准治疗方法。

材料/方法:在1985年至2002年期间,对117例患有颈段或胸上段气管狭窄的患者实施了节段性气管切除并进行一期端端吻合术。患者年龄分布在7岁至77岁之间。在101例良性气管狭窄患者中,有足够的数据进行回顾性分析。切除的气管节段长度在2至6厘米之间,这需要游离气管和喉部,必要时还需切开肺韧带。

结果

5例患者出现喉返神经永久性损伤,其中4例接受了翻修手术,术后10个月,93%的患者气管腔大且稳定,无任何相关再狭窄。101例患者中有3%因70%至80%的再狭窄导致静息时呼吸困难而不得不接受翻修手术。4%的患者出现30%至40%的轻度无症状再狭窄,无需进一步治疗。

结论

这些结果表明,节段性气管切除术能够安全有效地切除长达6厘米的狭窄气管节段,因此是首选的治疗方法。

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