Kuo M, Ho C M, Wei W I, Lam K H
Department of Surgery, University of Hong Kong.
Laryngoscope. 1994 Jan;104(1 Pt 1):59-63. doi: 10.1288/00005537-199401000-00010.
Stenosis of the terminal tracheostome is a distressing complication of total laryngectomy. A retrospective analysis of 207 patients who underwent total laryngectomy is presented; an overall incidence of tracheostomal stenosis of 13% is reported. The incidence of tracheostomal stenosis is higher in females (26%), patients having immediate tracheoesophageal puncture (19%), pectoralis major myocutaneous flap pharyngeal reconstruction (26%), and tracheostomal infection (50%) which is shown to be significant (P < .05). However, on multivariate analysis, only female sex and tracheostomal infection are independent determinants. Recognition of these clinical factors identifies patients at increased risk of developing this complication and thus allows appropriate perioperative planning to minimize its incidence.
终末气管造口狭窄是全喉切除术令人苦恼的并发症。本文对207例行全喉切除术的患者进行了回顾性分析；报告气管造口狭窄的总体发生率为13%。气管造口狭窄在女性患者（26%）、即刻行气管食管穿刺的患者（19%）、采用胸大肌肌皮瓣进行咽部重建的患者（26%）以及发生气管造口感染的患者（50%）中发生率更高，差异具有统计学意义（P < 0.05）。然而，多因素分析显示，只有女性性别和气管造口感染是独立的决定因素。认识到这些临床因素可识别出发生该并发症风险增加的患者，从而有助于进行适当的围手术期规划，以尽量降低其发生率。
