Akaogi E, Yuasa H, Ishibashi O, Inage Y, Dai Y, Sato Y, Ishikawa S, Morita R, Onizuka M, Mitsui K
Department of Surgery, University of Tsukuba.
Kyobu Geka. 1992 Jan;45(1):35-9.
Ten cases of central airway obstruction mainly caused by extrinsic compression due to the growth of extratracheal malignant tumors or longitudinal extension of tracheal adenoid cystic carcinomas, underwent palliative intubation subsequent to endoscopic Nd-YAG laser treatment. Mean length of the severe stenosis in these cases was 4.4 cm (3-7 cm). Sole application of endoscopic Nd-YAG laser to the stenosis failed relief of the symptom and an immediate palliative intubation was recommended. Mean time of the temporary intubation was 7 days (4-11 days). Airway was maintained by this intubation and also retained enough after extubation. Therefore, it seemed that, in a palliative treatment of the central airway severe stenosis, usefulness of the combination management of Nd-YAG laser with following temporary intubation was revealed. However, in order to maintain the airway for recurrence of the obstruction, use of indwelling airway stents seemed a better application. The longest period of follow-up in the cases treated by indwelling airway stents was 6 months and one of the cases is a now in comfortable state.
10例主要由气管外恶性肿瘤生长或气管腺样囊性癌纵向蔓延导致外部压迫引起的中央气道阻塞患者，在内镜下Nd-YAG激光治疗后接受了姑息性插管。这些病例中严重狭窄的平均长度为4.4厘米（3 - 7厘米）。仅对内窥镜下Nd-YAG激光治疗狭窄未能缓解症状，因此建议立即进行姑息性插管。临时插管的平均时间为7天（4 - 11天）。通过该插管维持了气道，拔管后也保留了足够的气道。因此，在中央气道严重狭窄的姑息治疗中，似乎显示出Nd-YAG激光与后续临时插管联合治疗的有效性。然而，为了维持气道以应对阻塞复发，使用留置气道支架似乎是更好的选择。接受留置气道支架治疗的病例最长随访期为6个月，其中1例目前状态良好。
