Adachi K, Umezaki T, Kiyohara H, Miyaji H, Komune S
Department of Otorhinolaryngology,Graduate School of Medical Sciences, Kyushu University,Fukuoka,Japan.
J Laryngol Otol. 2015 Mar;129 Suppl 2:S69-73. doi: 10.1017/S0022215114002424.
The purpose of the present study was to examine the clinical outcomes of using tracheoesophageal diversion for preventing intractable aspiration.
We retrospectively reviewed 25 patients who underwent tracheoesophageal diversion from 2003 to 2009 at our hospital (median age, 25 years; range, 0-78 years). End-to-side anastomosis was used in 16 cases and side-to-side anastomosis was used in 9.
The average operative time was 141 minutes for end-to-side anastomosis and 191 minutes for side-to-side anastomosis. Peri-operative complications were observed in only two (8 per cent) cases: one with infection and one with haematoma. No fistulas were observed. Aspiration was prevented in all cases, but the nutritional route depended on the swallowing function of the patient. Oral feeding was the main nutritional route after surgery in only four patients (16 per cent).
This procedure is well suited to patients who lack speech communication and are at high risk of aspiration.
本研究旨在探讨采用气管食管分流术预防顽固性误吸的临床效果。
我们回顾性分析了2003年至2009年在我院接受气管食管分流术的25例患者(中位年龄25岁;范围0至78岁)。其中16例采用端侧吻合,9例采用侧侧吻合。
端侧吻合的平均手术时间为141分钟,侧侧吻合为191分钟。围手术期仅2例(8%)出现并发症:1例感染,1例血肿。未观察到瘘管形成。所有病例的误吸均得到预防,但营养途径取决于患者的吞咽功能。术后仅4例患者(16%)以经口进食为主要营养途径。
该手术非常适合缺乏言语交流且误吸风险高的患者。