Parshin V D, Rusakov M A, Titov V A, Parshin V V, Khoruzhenko A I, Ivanova M A
Pervyĭ Moskovskiĭ gosudarstvennyĭ meditsinskiĭ universitet im. I.M. Sechenova.
Khirurgiia (Mosk). 2015(1):4-11. doi: 10.17116/hirurgia201514-10.
Treatment of multifocal and extended tracheal stenosis is associated with considerable difficulties in comparison with local lesions. Resection with restoration of respiratory lumen by using of direct intertracheal anastomosis substantially entered into common clinical practice. But these interventions in patients with two-level lesion are performed rarely. Among 900 operated patients with cicatrical tracheal stenosis resection of two tracheal segments with forming of anastomoses was performed only in 5 patients. We presented an experience of single-stage resections of different segments of respiratory tract for nonneoplastic cicatrical stenosis. Indications and contraindications are defined. Technical features of resection are discussed. Our data show that such operations are possible and safe. All patients recovered. Their breath was completely restored. Risk of postoperative complications after similar operations is not higher than after one-level resection. But at present time these techniques may be used by specialists and institutions with serious experience in tracheal surgery.
与局限性病变相比，多灶性和广泛性气管狭窄的治疗存在相当大的困难。通过直接气管内吻合术恢复呼吸腔的切除术已基本纳入常规临床实践。但在两级病变患者中，这类手术很少进行。在900例接受手术的瘢痕性气管狭窄患者中，仅5例患者进行了两个气管节段的切除并形成吻合术。我们介绍了针对非肿瘤性瘢痕性狭窄进行呼吸道不同节段一期切除的经验。明确了适应证和禁忌证。讨论了切除的技术特点。我们的数据表明，这类手术是可行且安全的。所有患者均康复。他们的呼吸完全恢复。类似手术后的术后并发症风险不高于一级切除术后。但目前，这些技术可能仅由在气管外科方面有丰富经验的专家和机构使用。
