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滑式气管成形术后先天性气管狭窄的长期转归。

Long- term outcomes of congenital tracheal stenosis after slide tracheoplasty.

机构信息

Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7, Minatojima-minamimachi, Chuo-ku, Kobe-shi, Japan.

出版信息

Pediatr Surg Int. 2024 Mar 20;40(1):84. doi: 10.1007/s00383-024-05670-8.

Abstract

PURPOSE

Long-term outcomes of slide tracheoplasty in patients with congenital tracheal stenosis (CTS) have rarely been reported. This study aimed to clarify the long-term outcomes of CTS after slide tracheoplasty.

METHODS

The medical records of 33 patients who underwent slide tracheoplasty for CTS at our institution between January 2005 and July 2018, with a follow-up duration > 5 years, were retrospectively reviewed. Patients' characteristics, perioperative condition, operative management, postoperative course, tracheal stenosis rates and growth data, were collected from medical records.

RESULTS

The median operative age, minimum tracheal diameter, length of stenosis, duration of hospital stays, and follow-up duration were 8 months, 2.4 mm, 35 mm, 39 days, and 90 months, respectively. One patient died of bleeding in the right lung at 126 months postoperatively. Among the 10 patients requiring postoperative tracheostomy, seven were successfully decannulated at a median of 65 months postoperatively. Tracheal stenosis rates improved postoperatively and were subsequently maintained. Growth impairment and psychomotor delay were observed in 9 and 16 patients, respectively with significant differences found only in cases with genetic abnormalities and not in tracheal stenosis severity.

CONCLUSION

Slide tracheoplasty for CTS leads to favorable long-term outcomes. However, various associated anomalies may influence growth and psychomotor development, emphasizing the importance of adequate support.

摘要

目的

先天性气管狭窄(CTS)患者行滑动气管成形术的长期结果鲜有报道。本研究旨在阐明 CTS 患者行滑动气管成形术后的长期结果。

方法

回顾性分析 2005 年 1 月至 2018 年 7 月在我院行滑动气管成形术治疗 CTS 且随访时间超过 5 年的 33 例患者的病历资料。收集患者的一般资料、围手术期情况、手术管理、术后经过、气管狭窄发生率和生长数据。

结果

中位手术年龄、最小气管直径、狭窄长度、住院时间和随访时间分别为 8 个月、2.4mm、35mm、39 天和 90 个月。1 例患者术后 126 个月因右肺出血死亡。10 例需要术后气管切开的患者中,7 例在术后 65 个月时成功拔管。术后气管狭窄率改善,随后得到维持。9 例患者出现生长发育障碍,16 例患者出现精神运动发育迟缓,仅在存在遗传异常的患者中发现显著差异,而与气管狭窄严重程度无关。

结论

滑动气管成形术治疗 CTS 可获得良好的长期结果。然而,各种相关畸形可能会影响生长和精神运动发育,这强调了充分支持的重要性。

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