Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Hangzhou 310016, China.
Department of Respiratory and Critical Care Medicine, The Second Hospital of Jiaxing, Jiaxing 314000, China.
Math Biosci Eng. 2019 Aug 27;16(6):7839-7849. doi: 10.3934/mbe.2019394.
With the improvement of surgical operation, increasing incidence of secondary benign airway stenosis, as a complication of long-term tracheal intubation and tracheotomy, leads to significant increases in morbidity and mortality. Previous treatment of secondary benign airway stenosis was mainly based on surgical resection and reconstruction. There is an urgent need for new treatment methods except surgery, especially for those inoperable patients. This study retrospectively reviewed 20 patients who had treatments of secondary benign airway stenosis after tracheotomy with Montgomery T-tube. The clinical data including clinical features, efficacy, complications and prognosis were retrospectively evaluated. Complete airway obstruction was 12/20, partial stenosis was 8/20, combined with airway granuloma and endoscopic granulation resection was 16/20, combined with scar stenosis and endoscopic balloon dilatation was 18/20. Plugging successfully was 19/20. Complications included mucous accumulation (20/20), secondary granulation tissue formation (13/20), subcutaneous soft tissue infection (1/20), and T-tube re-implantation (3/20). Montgomery T-tube implantation under rigid bronchoscopy is a safe, feasible and effective tracheal forming method with well tolerance for patients with benign airway stenosis. Secondary benign airway stenosis after tracheal intubation and tracheotomy is an indication of Montgomery T-tube implantation. Compared with the traditional tracheotomy, the advantage of Montgomery T-tube implantation is easy to make the patient phonate, significantly improving the quality of life of patients. T-tube implantation is safe, and the postoperative complications include mucous accumulation and formation of secondary T-tube granulation tissue.
随着手术技术的提高，作为长期气管插管和气管切开的并发症，继发性良性气道狭窄的发病率不断增加，导致发病率和死亡率显著增加。既往继发性良性气道狭窄的治疗主要基于手术切除和重建。除手术外，迫切需要新的治疗方法，尤其是对于那些不能手术的患者。本研究回顾性分析了 20 例经 Montgomery T 管治疗气管切开后继发性良性气道狭窄的患者。回顾性评估了包括临床特征、疗效、并发症和预后在内的临床资料。完全气道阻塞 12/20 例，部分狭窄 8/20 例，合并气道肉芽肿和内镜肉芽切除术 16/20 例，合并瘢痕狭窄和内镜球囊扩张术 18/20 例。19/20 例塞子成功。并发症包括黏液积聚（20/20）、继发性肉芽组织形成（13/20）、皮下软组织感染（1/20）和 T 管再植入（3/20）。硬质支气管镜下植入 Montgomery T 管是一种安全、可行、有效的气管成形方法，患者耐受性良好。气管插管和气管切开后的继发性良性气道狭窄是 Montgomery T 管植入的适应证。与传统气管切开术相比，Montgomery T 管植入术的优点是容易使患者发声，显著提高患者的生活质量。T 管植入术安全，术后并发症包括黏液积聚和继发性 T 管肉芽组织形成。
