氣管良性狹窄袖式切除重建外科治療_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

馬胡賽 ^1,2 , 蔡奕欣 ¹ , 張霓 ¹ ,  付向寧 ¹

1. ;
2. ;

Corresponding?author：

付向寧, Email: fuxn2006@yahoo.com.cn

Keywords：

氣管狹窄; 袖式切除術; 氣管重建

DOI：

10.7507/1007-4848.20140199

Video：

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目的探討氣管良性狹窄的臨床特點和外科手術治療策略。方法回顧性分析2011年1月至2013年12月同濟醫院胸外科收治的15例氣管良性狹窄患者的臨床資料，男11例、女4例，年齡10～57（34.52±2.45）歲；均為氣管內插管后發生狹窄，頸段氣管良性狹窄13例，氣管中段2例。6例患者行氣管狹窄切除并端端吻合重建術，9例行氣管狹窄切除端端吻合橫行氣管切開術。結果本組15例患者均安全度過麻醉期和手術期，全組無手術死亡。術后發生切口感染及氣胸各1例，所有患者均順利出院。隨訪3～36個月，所有患者日常活動正常，無呼吸困難癥狀，無再狹窄發生。結論氣管良性狹窄的治療首選氣管袖式切除重建手術治療，預防性氣管切開利于術后呼吸道管理，減少并發癥的發生。

Citation： 馬胡賽, 蔡奕欣, 張霓, 付向寧. 氣管良性狹窄袖式切除重建外科治療. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 695-696. doi: 10.7507/1007-4848.20140199 Copy

1.	Pookamala S, Kumar R, Thakar A, et al. Laryngotracheal stenosis:clinical profile, surgical management and outcome. Indian J Otolaryngol Head Neck Surg, 2014, 66(Suppl 1):198-202.
2.	Barreiro TJ, Ghattas C, Valino CA. Iatrogenic tracheal stenosis presenting as persistent asthma. Respir Care, 2013, 58(9):e107-e110.
3.	Carretta A, Melloni G, Ciriaco P, et al. Preoperative assessment in patients with postintubation tracheal stenosis:Rigid and flexible bronchoscopy versus spiral CT scan with multiplanar reconstructions. Surg Endosc, 2006, 20(6):905-908.
4.	Bagheri R, Majidi M, Khadivi E, et al. Outcome of surgical treatment for proximal long segment post intubation tracheal stenosis. J Cardiothorac Surg, 2013, 8:35.
5.	Yamamoto K, Kojima F, Tomiyama K, et al. Meta-analysis of therapeutic procedures for acquired subglottic stenosis in adults. Ann Thorac Surg, 2011, 91(6):1747-1753.
6.	Halmos GB, Schuiringa FS, Palinko D, et al. Finding balance between minimally invasive surgery and laryngotracheal resection in the management of adult laryngotracheal stenosis. Eur Arch Otorhinolaryngol, 2014, 43(11):417-418.
7.	Hashemzadeh S, Hashemzadeh K, Kakaei F, et al. Surgical treatment of postintubation tracheal stenosis:Iranian experience of effect of previous tracheostomy. Int J Gen Med, 2012, 5(3):93-98.
8.	Gallagher TQ, Hartnick CJ. Tracheal resection and reanastomosis. Adv Otorhinolaryngol, 2012, 73(21):50-57.
9.	Stoelben E, Koryllos A, Beckers F, et al. Benign stenosis of the trachea. Thorac Surg Clin, 2014, 24(1):59-65.
10.	Lin S, Huang H, Liu X, et al. Treatments for complications of tracheal sleeve resection for papillary thyroid carcinoma with tracheal invasion. Eur J Surg Oncol, 2014, 40(2):176-181.
11.	Ye J, Hu YM, Liu H, et al. Cervical tracheal resection with primary anastomosis for benign tracheal stricture in adult. Chin J otorhinolaryngol head neck surg, 2013, 48(7):568-572.
12.	Marulli G, Rizzardi G, Bortolotti L, et al. Single-staged laryngotracheal resection and reconstruction for benign strictures in adults. Interact Cardiovasc Thorac Surg, 2008, 7(2):227-230.
13.	Wright CD, Grillo HC, Wain JC, et al. Anastomotic complications after tracheal resection:prognostic factors and management. J Thorac Cardiovasc Surg, 2004, 128(5):731-739.
14.	Rubikas R, Matukaityte I, Jelisiejevas JJ, et al. Surgical treatment of non-malignant laryngotracheal stenosis. Eur Arch Otorhinolaryngol, 2014, 82(7):131-134.
15.	Ahn SH, Sung MW, Kim KH. Factors associated with staged reconstruction and successful stoma closure in tracheal resection and end-to-end anastomosis. Arch Otolaryngol Head Neck Surg, 2004, 130(1):57-62.
16.	李清云, 陳余思.經纖維支氣管鏡置入支架治療氣道狹窄26例臨床分析.中國內鏡雜志, 2008, 14(5):542-543.
17.	王利一, 黃魏寧.欽激光治療氣管內狹窄九例.中華老年醫學雜志, 2006, 4(25):277-278.

1. Pookamala S, Kumar R, Thakar A, et al. Laryngotracheal stenosis:clinical profile, surgical management and outcome. Indian J Otolaryngol Head Neck Surg, 2014, 66(Suppl 1):198-202.
2. Barreiro TJ, Ghattas C, Valino CA. Iatrogenic tracheal stenosis presenting as persistent asthma. Respir Care, 2013, 58(9):e107-e110.
3. Carretta A, Melloni G, Ciriaco P, et al. Preoperative assessment in patients with postintubation tracheal stenosis:Rigid and flexible bronchoscopy versus spiral CT scan with multiplanar reconstructions. Surg Endosc, 2006, 20(6):905-908.
4. Bagheri R, Majidi M, Khadivi E, et al. Outcome of surgical treatment for proximal long segment post intubation tracheal stenosis. J Cardiothorac Surg, 2013, 8:35.
5. Yamamoto K, Kojima F, Tomiyama K, et al. Meta-analysis of therapeutic procedures for acquired subglottic stenosis in adults. Ann Thorac Surg, 2011, 91(6):1747-1753.
6. Halmos GB, Schuiringa FS, Palinko D, et al. Finding balance between minimally invasive surgery and laryngotracheal resection in the management of adult laryngotracheal stenosis. Eur Arch Otorhinolaryngol, 2014, 43(11):417-418.
7. Hashemzadeh S, Hashemzadeh K, Kakaei F, et al. Surgical treatment of postintubation tracheal stenosis:Iranian experience of effect of previous tracheostomy. Int J Gen Med, 2012, 5(3):93-98.
8. Gallagher TQ, Hartnick CJ. Tracheal resection and reanastomosis. Adv Otorhinolaryngol, 2012, 73(21):50-57.
9. Stoelben E, Koryllos A, Beckers F, et al. Benign stenosis of the trachea. Thorac Surg Clin, 2014, 24(1):59-65.
10. Lin S, Huang H, Liu X, et al. Treatments for complications of tracheal sleeve resection for papillary thyroid carcinoma with tracheal invasion. Eur J Surg Oncol, 2014, 40(2):176-181.
11. Ye J, Hu YM, Liu H, et al. Cervical tracheal resection with primary anastomosis for benign tracheal stricture in adult. Chin J otorhinolaryngol head neck surg, 2013, 48(7):568-572.
12. Marulli G, Rizzardi G, Bortolotti L, et al. Single-staged laryngotracheal resection and reconstruction for benign strictures in adults. Interact Cardiovasc Thorac Surg, 2008, 7(2):227-230.
13. Wright CD, Grillo HC, Wain JC, et al. Anastomotic complications after tracheal resection:prognostic factors and management. J Thorac Cardiovasc Surg, 2004, 128(5):731-739.
14. Rubikas R, Matukaityte I, Jelisiejevas JJ, et al. Surgical treatment of non-malignant laryngotracheal stenosis. Eur Arch Otorhinolaryngol, 2014, 82(7):131-134.
15. Ahn SH, Sung MW, Kim KH. Factors associated with staged reconstruction and successful stoma closure in tracheal resection and end-to-end anastomosis. Arch Otolaryngol Head Neck Surg, 2004, 130(1):57-62.
16. 李清云, 陳余思.經纖維支氣管鏡置入支架治療氣道狹窄26例臨床分析.中國內鏡雜志, 2008, 14(5):542-543.
17. 王利一, 黃魏寧.欽激光治療氣管內狹窄九例.中華老年醫學雜志, 2006, 4(25):277-278.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

氣管良性狹窄袖式切除重建外科治療

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