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用于良性喉气管阻塞的内镜手术和CO激光辅助手术训练的羊喉模型。

Lamb larynx model for training in endoscopic and CO laser-assisted surgeries for benign laryngotracheal obstructions.

作者信息

Gorostidi François, Vinckenbosch Pauline, Lambercy Karma, Sandu Kishore

机构信息

Department of Otolaryngology, Head and Neck Surgery, University Hospital of Lausanne (CHUV), Bugnon 46, 1011, Lausanne, Switzerland.

出版信息

Eur Arch Otorhinolaryngol. 2018 Aug;275(8):2061-2069. doi: 10.1007/s00405-018-5011-7. Epub 2018 Jun 4.

Abstract

PURPOSE

With adequate indication and meticulous execution, endoscopic procedures can efficiently treat a subset of adult and pediatric benign laryngotracheal stenosis and obstructions, but these procedures are precise and very demanding. The difference between a successful and a failed surgery, with potentially debilitating side effects, resides in small details. The learning curve is long and very few centers worldwide have a sufficient case load making adequate training difficult. While indications and concepts of endoscopic procedures can be learned in books and by observing trained colleagues, the dexterity and the precise realization need to be practiced, ideally not initially on patients.

METHODS

We describe here the lamb model system for the initial training in such procedures. We provide a step-by-step guide for endoscopic approaches intended to treat pathologies such as laryngomalacia, bilateral vocal fold paralysis, posterior glottic stenosis, and laryngotracheal clefts.

CONCLUSIONS

The lamb model system does not pose ethical issues, and it is easy to obtain and to handle. It was used during an international training course for laryngotracheal stenosis by novice and advanced airway surgeons. It was unanimously judged as relevant and useful by the participants.

摘要

目的

在有充分适应证且操作细致的情况下,内镜手术能够有效治疗一部分成人和儿童的良性喉气管狭窄及梗阻,但这些手术操作精细且要求极高。成功手术与失败手术之间的差异,以及可能带来的严重副作用,都存在于细微之处。学习曲线漫长,全球范围内很少有中心有足够的病例量,这使得充分的培训变得困难。虽然内镜手术的适应证和概念可以通过书本学习以及观察有经验的同事来掌握,但操作的灵活性和精确性需要进行练习,理想情况下最初不应在患者身上进行。

方法

我们在此描述用于此类手术初始培训的羔羊模型系统。我们提供了一份内镜手术方法的分步指南,旨在治疗诸如喉软化症、双侧声带麻痹、声门后狭窄和喉气管裂等病症。

结论

羔羊模型系统不存在伦理问题,易于获取和操作。它在一次针对喉气管狭窄的国际培训课程中被新手和经验丰富的气道外科医生使用。参与者一致认为它相关且有用。

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