Okada Y, Handa M, Ohura H, Shimada K, Hirose M, Horikoshi A, Saito Y, Sagawa M, Kondo J, Fujimura S
Department of Thoracic Surgery, Tohoku University, Sendai, Japan.
Kyobu Geka. 1994 May;47(5):379-82.
An experience of suprahyoid release for resection and reconstruction of the lower part of trachea was reported. 51-year-old woman, complaining of continuous stridor, was diagnosed as tracheal tumor at another hospital and was transferred to our hospital for consecutive examination and surgical treatment. The size of the tumor was about 3 cm in longitudinal diameter and the distance between tracheal carina and lower edge of the tumor was estimated about 2 cm by tomography. At operation, following suprahyoid release in supine position, 6 tracheal rings were resected and reconstructed by end-to-end anastomosis through right posterolateral incision. Patients neck was forced to bend for three weeks and intravenous byperalimentation without oral intake was employed for two weeks to avoid misswallowing and dysphagia postoperatively. Oral intake was started at two weeks after operation and parenteral nutrition was no more necessary at 3 weeks after surgery. Misswallowing and dysphagia were not encountered at all. The tumor was diagnosed as adenoid cystic carcinoma pathologically and residual tumor was demonstrated in submucosal space at the oral margin of the resected specimen as well. She discharged from the hospital uneventfully after postoperative radiotherapy. The recurrence of the tumor has not been observed for 3 years postoperatively. It was confirmed that suprahyoid release is an useful technique and should be ready to introduce in the extensive resection of the trachea because of its little influence on laryngeal function.
报告了1例舌骨上松解术用于气管下段切除重建的经验。一名51岁女性,因持续性喘鸣在另一家医院被诊断为气管肿瘤,随后转入我院进行进一步检查和手术治疗。肿瘤纵向直径约3 cm,通过断层扫描估计气管隆突与肿瘤下缘之间的距离约为2 cm。手术时,患者仰卧位行舌骨上松解术,切除6个气管环,经右后外侧切口端端吻合重建。术后3周内患者颈部保持屈曲位,2周内采用静脉高营养支持且禁食,以避免术后误咽和吞咽困难。术后2周开始经口进食,术后3周不再需要肠外营养支持。患者未出现误咽和吞咽困难。病理诊断为腺样囊性癌,切除标本切缘黏膜下间隙可见残留肿瘤。术后放疗后患者顺利出院。术后3年未见肿瘤复发。证实舌骨上松解术是一种有用的技术,因其对喉功能影响小,应准备在气管广泛切除术中应用。