Laccourreye O, Brasnu D, Seckin S, Hans S, Biacabe B, Laccourreye H
Department of Otorhinolaryngology-Head and Neck Surgery, Laënnec Hospital, University Paris V, France.
Arch Otolaryngol Head Neck Surg. 1997 Oct;123(10):1074-7. doi: 10.1001/archotol.1997.01900100048007.
To review the long-term results and our experience with cricotracheal anastomosis via a cervical approach for assisted ventilation-induced stenosis.
A case series of 41 patients consecutively treated with cricotracheal anastomosis.
A tertiary care center and university teaching hospital.
Group 1 consisted of 22 patients with stenosis reaching the lower border of the cricoid cartilage that did not require resection of the cricoid cartilage. Group 2 consisted of 19 patients in whom correction of the stenosis required cricoid resection.
Statistical analysis of airway patency was based on the Kaplan-Meier actuarial life table method. Incidence for the various postoperative complications was presented. Univariate analysis was performed to analyze the relationships between various factors, airway patency, and the incidence for the various complications encountered.
The Kaplan-Meier 5-year airway patency estimate was 100% in group 1 patients and 82.5% in group 2 patients. In group 2 patients, complementary treatment with dilatations in 2 patients resulted in an overall 94.8% airway patency rate. In the last patient, the airway patency was not reestablished after cricotracheal anastomosis, and a Montgomery T tube was inserted. Postoperative complications included unilateral inferior laryngeal nerve paralysis (3 patients), cervical neck abscess (2 patients), pneumothorax (1 patient), and major subcutaneous emphysema (1 patient). None of the following variables was statistically related to the airway patency or to the various complications encountered: sex, age, cause for stenosis, delay from initial injury, prior treatment, presence of a tracheotomy, number of tracheal rings resected, type of sutures used, and type of anastomosis performed.
The data reported reemphasized that cricotracheal anastomosis with or without cricoid resection is a safe and reliable procedure for assisted ventilation-induced upper tracheal stenosis reaching and/or involving the subglottis and/or cricoid cartilage.
回顾经颈部入路行环状气管吻合术治疗辅助通气所致狭窄的长期结果及我们的经验。
对41例行环状气管吻合术的患者进行病例系列研究。
三级医疗中心和大学教学医院。
第1组由22例狭窄累及环状软骨下缘且无需切除环状软骨的患者组成。第2组由19例狭窄矫正需要切除环状软骨的患者组成。
基于Kaplan-Meier精算寿命表法对气道通畅情况进行统计分析。列出各种术后并发症的发生率。进行单因素分析以分析各种因素、气道通畅情况与所遇到的各种并发症发生率之间的关系。
第1组患者的Kaplan-Meier 5年气道通畅率估计为100%，第2组患者为82.5%。在第2组患者中，2例患者进行扩张补充治疗后，总体气道通畅率为94.8%。在最后1例患者中，环状气管吻合术后气道未能重新通畅，遂插入蒙哥马利T形管。术后并发症包括单侧喉返神经麻痹（3例）、颈部脓肿（2例）、气胸（1例）和严重皮下气肿（1例）。以下变量均与气道通畅情况或所遇到的各种并发症无统计学关联：性别、年龄、狭窄原因、初始损伤后的延迟时间、既往治疗、气管切开的存在情况、切除的气管环数量、所用缝线类型和所进行的吻合类型。
所报告的数据再次强调，无论是否切除环状软骨，环状气管吻合术对于辅助通气所致累及声门下和/或环状软骨的上气管狭窄是一种安全可靠的手术方法。
Zotero 插件