Griffith G R, Luce E A
Plast Reconstr Surg. 1982 Dec;70(6):694-8. doi: 10.1097/00006534-198212000-00006.
Stenosis of the postlaryngectomy tracheal stoma remains a persistent problem. A retrospective study of 89 patients determined on overall incidence of 22 percent. The use of postoperative radiotherapy was associated with a higher incidence (36 percent) than preoperative radiotherapy (19 percent) and combined preoperative and postoperative radiotherapy (17 percent). Retention of the tracheal cannula for longer than 1 week was associated with a slightly increased incidence (25 percent) of stenosis. The technique of stomal construction was an important determinant of stoma stenosis. A simple circle of straight transection of the trachea had the highest incidence (29 percent) of stenosis, which could be reduced with a beveled technique (15 percent). The lowest incidence was seen with a primary plastic or flap construction technique (8 percent). The authors recommend the construction of a patulous stoma by a technique of beveling transection of the tracheal stump in combination with the use of interdigitation skin flaps.
喉切除术后气管造口狭窄仍然是一个长期存在的问题。一项对89例患者的回顾性研究确定总体发生率为22%。术后放疗的发生率（36%）高于术前放疗（19%）以及术前和术后联合放疗（17%）。气管套管留置超过1周与狭窄发生率略有增加（25%）相关。造口构建技术是造口狭窄的一个重要决定因素。单纯的气管直线横断圆形造口狭窄发生率最高（29%），采用斜面技术可降低发生率（15%）。采用一期整形或皮瓣构建技术发生率最低（8%）。作者建议采用气管残端斜面横断技术并结合指状皮瓣的使用来构建宽敞的造口。
