Fernandez-Bussy Sebastian, Mahajan Bob, Folch Erik, Caviedes Ivan, Guerrero Jorge, Majid Adnan
*Interventional Pulmonology, Clinica Alemana-Universidad del Desarrollo, Santiago, Chile †Interventional Pulmonology, Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Thoracic Surgery and Interventional Pulmonology, Boston, MA ‡Interventional Pulmonology, Central Florida Pulmonary Group, Orlando, FL.
J Bronchology Interv Pulmonol. 2015 Oct;22(4):357-64. doi: 10.1097/LBR.0000000000000177.
Tracheostomy tube placement is a therapeutic procedure that has gained increased favor over the past decade. Upper airway obstructions, failure to liberate from the ventilator, and debilitating neurological conditions are only a few indications for tracheostomy tube placement. Tracheostomy tubes can be placed either surgically or percutaneously. A percutaneous approach offers fewer surgical site infections and postsurgical bleeding than a surgical approach. A surgical placement posses a lower risk of injury to the posterior tracheal wall and spontaneous decannulation is less common. Late complications of both approaches include stenosis, malacia, along with tracheoesophageal, tracheoinnominate, and tracheocutaneous fistulas. This review describes the indications and methods of placement of tracheostomy tubes along with early and late complications that may occur following placement.
气管切开置管是一种治疗性操作,在过去十年中越来越受到青睐。上呼吸道梗阻、无法脱离呼吸机以及衰弱的神经系统疾病只是气管切开置管的少数适应证。气管切开管可通过手术或经皮放置。与手术方法相比,经皮方法导致的手术部位感染和术后出血较少。手术放置对气管后壁的损伤风险较低,且自发性脱管不太常见。两种方法的晚期并发症包括狭窄、软化,以及气管食管瘘、气管无名动脉瘘和气管皮肤瘘。本综述描述了气管切开管的放置适应证、方法以及放置后可能发生的早期和晚期并发症。