Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy.
Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4459-4467. doi: 10.1007/s00405-021-06674-z. Epub 2021 Feb 13.
The aim of the present article is to propose an alternative technique to the traditional secondary tracheoesophageal puncture (TEP) for voice rehabilitation after total laryngectomy, describing the procedure step-by-step, analyzing the complications and long-term results.
A retrospective study was conducted on patients who underwent secondary TEP with the blind technique using a rigid hysterometer. The main steps in this technique are described and illustrated. Patient demographics and surgical outcomes were assessed.
Thirty-two patients were enrolled in this study. In all but one case, risk factors that could hinder rigid esophagoscopy were identified (37.5% neopharyngeal/esophageal post-surgical issues, 81.3% prior radiotherapy, 21.9% cervical arthrosis, and 12.5% prior coloplasty or gastric transposition). No intra- or postoperative surgical complications were noted.
The blind technique offers an alternative method to perform a secondary TEP safely and efficiently in patients with unfavorable anatomical or clinical conditions, lowering the risk of procedure-related complications.
本文旨在为全喉切除术后的嗓音康复提出一种替代传统二次气管食管造瘘术（TEP）的技术，逐步描述该手术步骤，分析其并发症和长期效果。
对采用硬性食管镜行盲法二次 TEP 的患者进行回顾性研究。本文对该技术的主要步骤进行了描述和说明。评估了患者的人口统计学和手术结果。
本研究共纳入 32 例患者。除 1 例患者外，所有患者均存在可能阻碍硬性食管镜检查的风险因素（37.5%新咽部/食管术后问题、81.3%放疗史、21.9%颈椎关节炎、12.5%结肠造口术或胃转位史）。无术中或术后手术并发症。
在解剖结构或临床条件不佳的患者中，盲法可安全有效地进行二次 TEP，降低与手术相关的并发症风险，是一种替代方法。
