Müller M R, Klepetko W, Rogy M, Eckersberger F, Wolner E
II. Chirurgische Universitätsklinik Wien.
Chirurg. 1991 Jul;62(7):547-51.
Tracheal problems in form of stenosis and malacia are a calculated risk of long-term tracheal intubation. Results with conservative treatment of such problems by bougienage, laser therapy, biopsy, cryotherapy, local steroids, tracheal stenting, and tracheostomy are not satisfactory in a higher percentage of cases. Resectional therapy of benign tracheal lesions has become an established technique, which combines excellent functional results with a low complication incidence. We have treated 40 patients of 17 to 76 years of age with postintubation tracheal lesions by cross resection of the affected segment. Of these patients 40% had received conservative therapeutical steps preoperatively. The mean resection length was 3.0 cm (1.5 to 6.5 cm). The perioperative morbidity was 7.8%, mortality was 2.5%. 85% of the patients operated between 1970 and 1989 were reached for a follow-up examination with x-ray, pulmonary function test and endoscopy. The patients subjective satisfaction with the operative result was good in 85%, minor in 12% and less in 3%. The objective investigations proved very good results in 90%. Our experience confirm the good results of other authors and recommend the resection treatment for cases of postintubation tracheal lesions.
气管狭窄和软化形式的气管问题是长期气管插管的一种可预见风险。通过探条扩张术、激光治疗、活检、冷冻疗法、局部使用类固醇、气管支架置入术和气管造口术等保守治疗此类问题的结果，在较高比例的病例中并不令人满意。良性气管病变的切除治疗已成为一种成熟的技术，它将良好的功能结果与低并发症发生率相结合。我们对40例年龄在17至76岁之间的插管后气管病变患者进行了病变节段的交叉切除。这些患者中有40%术前接受过保守治疗措施。平均切除长度为3.0厘米（1.5至6.5厘米）。围手术期发病率为7.8%，死亡率为2.5%。对1970年至1989年间接受手术的85%的患者进行了随访检查，包括X线、肺功能测试和内镜检查。患者对手术结果的主观满意度为：良好占85%，一般占12%，较差占3%。客观检查显示90%的结果非常好。我们的经验证实了其他作者的良好结果，并推荐对插管后气管病变病例采用切除治疗。
