Bonnette P, Colchen A, Leroy M, Bisson A
Service de Chirurgie Thoracique, Hôpital Foch, Suresnes.
Rev Mal Respir. 1998 Oct;15(5):627-32.
Since 1975, 340 patients were treated by tracheal sleeve resection for tracheal or subglottic laryngeal iatrogenic stenoses in our unit. Preoperative iterative Nd YAG laser sessions have usually been performed, without success. The length of the sleeve specimen was an average of 3 1/4 cm. Twelve patients died on the post operative course (3.5%), 3 more patients died later after failure of the procedure (0.9%) and nineteen had recurrent stenoses treated with use of a tracheostomy tube, a permanent Montgomery tube, or an endotracheal stent (5.6%). Three hundred and six patients are definitely cured (90%), at the first attempt for 265 patients, after a laser session for granulomas for 20 patients, after a second tracheal resection for 6 patients and after a temporary Montgomery tube for 15 patients. Providing there is a good selection of the patients, tracheal sleeve resection is the best treatment for iatrogenic stenosis.
自1975年以来，我院对340例气管或声门下喉医源性狭窄患者进行了气管袖状切除术。术前通常进行多次Nd:YAG激光治疗，但均未成功。袖状标本的长度平均为3又1/4厘米。12例患者在术后过程中死亡（3.5%），另有3例患者在手术失败后死亡（0.9%），19例患者出现复发性狭窄，采用气管造口管、永久性蒙哥马利管或气管内支架治疗（5.6%）。306例患者（90%）得到确切治愈，其中265例患者首次手术治愈，20例患者经激光治疗肉芽肿后治愈，6例患者二次气管切除术后治愈，15例患者使用临时蒙哥马利管后治愈。如果对患者进行精心挑选，气管袖状切除术是医源性狭窄的最佳治疗方法。
