Cordos Ioan, Bolca Ciprian, Paleru Cristian, Posea Radu, Stoica Radu
1st Clinical Department of Thoracic Surgery, National Institute of Pneumology Marius Nasta, Bucharest, Romania.
Interact Cardiovasc Thorac Surg. 2009 Jan;8(1):62-5; discussion 65. doi: 10.1510/icvts.2008.184747. Epub 2008 Oct 8.
This study evaluates the clinical outcome following surgery of our patients for the last seven years. Between 2001 and 2008 we performed tracheal resections in 60 patients. There were 46 cases of postintubation stenosis and 14 tumors. The range of resected rings was 1-8. The maximal resection length performed in our series (4 cm) was achieved using only basic releasing maneuvers such as anterior dissection of the trachea and cervical flexion. Emergency tracheal resection with no complications was performed in 12 patients who presented with severe dyspnea due to very tight stenosis. One patient died during the surgical intervention from a stroke. There were two postoperative deaths, both in patients with tracheo-esophageal fistula. As major complications we mention one patient with restenosis who underwent revision surgery. Among the patients with malignant tumors we had one local epidermoid carcinoma recurrence 18 months after surgery and the two patients with thyroid cancer who died six and nine months later. Basic releasing maneuvers allow a good length of the trachea to be resected with no complications. We consider that emergency tracheal resection can be performed with success. Squamous cell carcinoma was the most frequent histological type in our series.
本研究评估了过去七年中我们患者手术后的临床结果。2001年至2008年间，我们对60例患者进行了气管切除术。其中有46例插管后狭窄病例和14例肿瘤病例。切除的气管环数量为1至8个。在我们的系列研究中，仅通过诸如气管前解剖和颈部屈曲等基本松解操作就实现了最长4厘米的切除长度。12例因严重狭窄导致严重呼吸困难的患者接受了无并发症的急诊气管切除术。1例患者在手术干预期间死于中风。有2例术后死亡，均为气管食管瘘患者。作为主要并发症，我们提到1例再狭窄患者接受了翻修手术。在恶性肿瘤患者中，有1例局部表皮样癌在术后18个月复发，2例甲状腺癌患者分别在术后6个月和9个月死亡。基本松解操作可实现气管的良好长度切除且无并发症。我们认为急诊气管切除术可以成功进行。鳞状细胞癌是我们系列研究中最常见的组织学类型。
