Özgül Mehmet Akif, Gül Şule, Çetinkaya Erdoğan, Turan Demet, Kırkıl Gamze, Uğur Chousein Efsun Gonca, Tanrıverdi Elif, Özgül Güler
Clinic of Chest Diseases, Istanbul Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Department of Chest Diseases, Faculty of Medicine, Fırat University, Elazig, Turkey.
Tuberk Toraks. 2019 Mar;67(1):55-62. doi: 10.5578/tt.68188.
The most common cause of tracheal stenosis (TS) continues to be traumas according to the intubation and tracheostomy. Bronchoscopy is considered the gold standard for the detection and diagnosis of tracheobronchial pathology. There are several treatment options. We aimed to discuss our tracheal stenosis patients' treatment options, and their follow-up period.
Consecutive referred patients between 2009 and 2018 presenting with TS were reviewed for the study. Demographic characteristics, localization, length and degree of stenosis, treatment techniques, postoperative complications, and survival were recorded for all patients.
A total of 110 patients included. The mean age was 53.7 ± 16.7 (16-98 years) years. Of 110 patients, 54 (49.1%) were female. Most common type of stenosis was complex stenosis (74.5%). Mechanical dilatation was applied to all patients. Stenotic regions of 22 (20%) patients were cut with bronchoscopic scissor. Tracheal stents were inserted into trachea of 49 (44.5%) patients. During follow-up period; 36 of 110 (32.7%) patients had surgical resection. Six of 36 (16.7%) patients died during follow-up period (one of them died during surgery), 17 (47.2%) patients had total recovery after surgery. Thirteen of 36 (36.1%) patients had restenosis after surgery.
Tracheal stenosis is a process seen after postintubation or posttracheostomy frequently and it has a wide range of management modalities. Although, it is believed that surgery is the most efficient technique in cases without medical contraindications, we determined that endoscopic interventions can be alternative therapeutic options for inoperable patients. Patients must be followed-up after interventional therapies because complications, and restenosis can usually be seen.
根据插管和气管切开术情况,气管狭窄(TS)最常见的病因仍是创伤。支气管镜检查被认为是气管支气管病变检测和诊断的金标准。有多种治疗选择。我们旨在讨论气管狭窄患者的治疗选择及其随访期。
回顾性研究2009年至2018年连续转诊的气管狭窄患者。记录所有患者的人口统计学特征、狭窄部位、长度和程度、治疗技术、术后并发症及生存率。
共纳入110例患者。平均年龄为53.7±16.7(16 - 98岁)岁。110例患者中,54例(49.1%)为女性。最常见的狭窄类型是复杂性狭窄(74.5%)。所有患者均接受了机械扩张。22例(20%)患者的狭窄部位用支气管镜剪刀进行了切割。49例(44.5%)患者的气管内插入了气管支架。在随访期间;110例患者中有36例(32.7%)接受了手术切除。36例患者中有6例(16.7%)在随访期间死亡(其中1例死于手术中),17例(47.2%)患者术后完全康复。36例患者中有13例(36.1%)术后出现再狭窄。
气管狭窄是插管或气管切开术后常见的一种情况,有多种治疗方式。虽然一般认为在无医学禁忌证的情况下手术是最有效的技术,但我们确定内镜干预可为无法手术的患者提供替代治疗选择。介入治疗后必须对患者进行随访,因为通常会出现并发症和再狭窄。