Chen Yong, Wang Wu-jun, Wang Hao-fei
Department of Thoracic and Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Jun;30(6):1359-62.
To compare the therapeutic effects of tracheal anastomosis and interventional bronchoscopy in the treatment of airway stenosis.
From February, 1990 to February 2008, 53 patients with airway stenosis including 32 male and 21 female patients aged 2 to 80 years (mean 38 years) received end-to-end anastomosis or bronchoscopic stent-graft treatment in our hospital. End-to-end anastomosis of the narrow sleeves resected was performed in 26 cases, balloon dilatation in 14 cases, and stent implantation in 13 cases. The clinical and follow-up data of the patients were analyzed retrospectively and the surgical outcomes were evaluated.
No perioperative deaths occurred in these cases. Eight patients (5 with anastomosis, 2 with balloon dilation, and 1 with stent implantation) were lost to the follow-up ranging from 1 to 204 (mean 44.94-/+54.56) months. Of the patients available to the follow-up, 12 had airway restenosis, including 2 receiving end-to-end anastomosis (9.5%), 6 (50%) receiving balloon angioplasty, and 6 with granulation hyperplasia following stent implantation (50%). Of the 3 treatment, end-to-end anastomosis was associated with the lowest restenosis rate (Chi2=8.869, P=0.012).
End-to-end anastomosis, with a low postoperative restenosis rate and better prognosis, should be the primary choice for treatment of tracheal airway stenosis.
比较气管吻合术与介入性支气管镜检查在气道狭窄治疗中的疗效。
1990年2月至2008年2月,我院对53例气道狭窄患者进行了端端吻合术或支气管镜支架植入治疗,其中男32例,女21例,年龄2至80岁(平均38岁)。26例行狭窄段袖状切除端端吻合术,14例行球囊扩张术,13例行支架植入术。回顾性分析患者的临床及随访资料并评估手术效果。
这些病例围手术期均无死亡。8例患者失访(5例行吻合术,2例行球囊扩张术,1例行支架植入术),失访时间为1至204个月(平均44.94±54.56个月)。在可随访的患者中,12例出现气道再狭窄,其中2例接受端端吻合术(9.5%),6例接受球囊血管成形术(50%),6例支架植入术后出现肉芽组织增生(50%)。三种治疗方法中,端端吻合术的再狭窄率最低(χ2=8.869,P=0.012)。
端端吻合术术后再狭窄率低,预后较好,应作为气管气道狭窄治疗的首选方法。