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使用可弯曲经光导(transillumination)设备行二次气管食管穿刺术:一种新技术及其结果。

Secondary tracheoesophageal puncture with a flexible transillumination device: a new technique and its outcomes.

机构信息

Universidade Estadual de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.

Universidade Estadual de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.

出版信息

Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 4(Suppl 4):S65-S69. doi: 10.1016/j.bjorl.2021.07.008. Epub 2021 Oct 17.

Abstract

OBJECTIVES

This study aims to describe a new secondary tracheoesophageal puncture technique with voice prosthesis insertion under local anesthesia with a low-cost device and evaluate its outcome.

METHODS

With a transoral flexible transillumination device of aluminum of 2.3 mm with fiberoptic light, the esophagus's anterior wall is visualized through the tracheostomy. A tracheoesophageal fistula is made with a blade and passed through the fistula. Then a bent trocar is introduced into the lumen using the device as a guidewire. Once in the lumen, a thin guide wire is passed through up to the mouth. The voice prosthesis is positioned with retrograde insertion. Then, the patient is discharged without hospitalization.

RESULTS

15 patients submitted to this technique had a successful surgical outcome. There were no complications as pneumothorax, esophageal perforation, bleeding, or hospitalization.

CONCLUSION

The new device is feasible under local anesthesia.

摘要

目的

本研究旨在描述一种新的经皮气管食管造瘘术,使用局麻、低成本设备及插入声门 成形 术,评估其效果。

方法

使用直径 2.3mm 的带有光纤光源的可弯曲经口透明喉镜,通过气管造口窥视食管前壁,用手术刀切开食管前壁,通过瘘口插入引导鞘管,然后将弯形穿刺器沿引导鞘管插入气管食管瘘口。一旦穿刺器进入管腔,就将一根细导丝通过穿刺器送至口腔。通过逆行插入将声门 成形 术 置 入。然后,患者无需住院即可出院。

结果

15 名患者接受了该技术,手术均成功,无气胸、食管穿孔、出血或住院等并发症。

结论

在局麻下使用新设备是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5f1/9756063/01efae7bdf1a/gr1.jpg

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