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对10年间因良性气管狭窄接受气管切除及端端吻合手术的患者进行的回顾性分析。

A retrospective analysis of patients who underwent tracheal resection and end-to-end anastomosis surgery for benign tracheal stenosis, over a 10-year period.

作者信息

Gülmez M İhsan, Kutay Funda, Aydın Canset, Akoğlu Ertap, Okuyucu Şemsettin

机构信息

Hatay Mustafa Kemal University Otorhinolaryngology Department, 31000, Turkey.

Hatay Mustafa Kemal University Otorhinolaryngology Department, 31000, Turkey.

出版信息

Am J Otolaryngol. 2024 Nov-Dec;45(6):104463. doi: 10.1016/j.amjoto.2024.104463. Epub 2024 Aug 2.

Abstract

INTRODUCTION

Laryngotracheal stenosis encompasses a diverse range of diagnoses, encompassing complete or partial narrowing of various subgroups of the upper airways, including the laryngeal structures and trachea, due to pathological scar formation. This increasingly prevalent pathology is of significant importance due to its potential for life-threatening consequences. Among the defined treatment modalities, tracheal resection and end-to-side anastomosis remain a valuable therapeutic alternative in appropriate indications.

OBJECTIVE

The objective of this study was to retrospectively evaluate the outcomes of patients who underwent tracheal resection and end-to-end anastomosis at our clinic over the past decade.

MATERIAL & METHOD: All patients who underwent tracheal resection and end-to-end anastomosis surgery for benign tracheal stenosis at the Department of Otolaryngology, Mustafa Kemal University Hospital between 2013 and 2023 were included in the study. The diagnosis of tracheal stenosis was based on endoscopic examination and computed tomography results. Interventions without postoperative symptoms and without the need for additional surgical intervention were considered successful. The study was approved by Hatay Mustafa Kemal University Ethics Committee with decision number 2023/27.

RESULTS

A total of 29 patients were included in the study. The mean age of the patients was 26.48 years. 3 patients (10.35 %) had a comorbidity. In all patients orotracheal intubation or intubation and tracheotomy was the aetiological cause. There were no intraoperative complications. In the postoperative period, wound infection was observed in 3 patients (10.35 %) and subcutaneous emphysema in 2 patients (6.9 %). In 1 patient (3.45 %) recurrent respiratory distress was observed, restenosis was considered and tracheotomy was performed. Our complication rate was 20.69 %. When all patients were evaluated at the end of the postoperative follow-up period, the surgical success rate was calculated to be 96.55 %.

CONCLUSION

With a surgical success rate of 96.55 % and a low complication rate in our study, we believe, in parallel with previous studies, that open surgery is a reliable, physiologically appropriate and successful method among the current treatments for tracheal stenosis.

摘要

引言

喉气管狭窄包含多种诊断情况,包括由于病理性瘢痕形成导致上呼吸道各亚组(包括喉部结构和气管)出现完全或部分狭窄。这种日益普遍的病理状况因其可能导致危及生命的后果而具有重要意义。在既定的治疗方式中,气管切除和端侧吻合术在适当的适应症中仍然是一种有价值的治疗选择。

目的

本研究的目的是回顾性评估过去十年在我们诊所接受气管切除和端端吻合术的患者的治疗结果。

材料与方法

纳入2013年至2023年在穆斯塔法·凯末尔大学医院耳鼻喉科因良性气管狭窄接受气管切除和端端吻合术的所有患者。气管狭窄的诊断基于内镜检查和计算机断层扫描结果。无术后症状且无需额外手术干预的干预被视为成功。该研究经哈塔伊穆斯塔法·凯末尔大学伦理委员会批准,批准号为2023/27。

结果

本研究共纳入29例患者。患者的平均年龄为26.48岁。3例患者(10.35%)有合并症。所有患者的病因均为口气管插管或插管及气管切开。术中无并发症。术后,3例患者(10.35%)出现伤口感染,2例患者(6.9%)出现皮下气肿。1例患者(3.45%)出现反复呼吸窘迫,考虑再狭窄并进行了气管切开术。我们的并发症发生率为20.69%。在术后随访期结束时对所有患者进行评估时,手术成功率计算为96.55%。

结论

在我们的研究中,手术成功率为96.55%,并发症发生率较低,我们与先前的研究一致认为,开放手术是目前气管狭窄治疗方法中一种可靠、生理上合适且成功的方法。

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