Grillo H C
Thorax. 1973 Nov;28(6):667-79. doi: 10.1136/thx.28.6.667.
, , 667-679. Anatomic mobilization of the trachea permits resection of one-half or more with primary anastomosis. An anterior approach by a cervical or cervicomediastinal route utilizes cervical flexion to devolve the larynx and tracheal mobilization with preservation of the lateral blood supply. The transthoracic route is employed for lower tracheal lesions. Over 100 tracheal resections have been done using these methods of direct reconstruction. Eighty-four patients suffered from benign strictures, 79 resulting from intubation injuries. Eleven primary tracheal tumours and five secondary tumours are included. The majority of lesions following intubation occurred at the level of the cuff. It was possible to repair 78 of the 84 stenotic lesions through a cervical or cervicomediastinal approach. Seventy-three of the 84 patients with inflammatory lesions obtained an excellent or good functional and anatomic result. Nine of 11 patients with primary neoplasms who underwent reconstruction are alive and without known disease. There were five early postoperative deaths in these 100 consecutive patients who underwent tracheal reconstruction.
气管的解剖游离可允许切除一半或更多并进行一期吻合。通过颈部或颈纵隔途径的前路手术利用颈部屈曲使喉部下降并进行气管游离,同时保留侧方血供。经胸途径用于较低部位的气管病变。使用这些直接重建方法已完成了100多例气管切除术。84例患者患有良性狭窄,其中79例由插管损伤引起。包括11例原发性气管肿瘤和5例继发性肿瘤。插管后大多数病变发生在袖带水平。84例狭窄病变中的78例可通过颈部或颈纵隔途径修复。84例炎性病变患者中有73例获得了良好或优秀的功能和解剖学结果。接受重建的11例原发性肿瘤患者中有9例存活且无已知疾病。在这100例连续接受气管重建的患者中有5例术后早期死亡。