喉气管狭窄合并气管食管瘘Ⅰ期手术治疗

Single-stagesurgery of laryngotracheal stenosis complicated with tracheoesphageal fistula

目的探讨喉气管狭窄合并气管食管瘘患者的Ⅰ期手术治疗效果。方法回顾性分析2007年3月-2017年3月诊治的喉气管狭窄合并气管食管瘘患者共6例的手术方式和治疗效果。根据喉气管狭窄范围和程度的不同,行喉气管狭窄切除,分别采用气管-甲状软骨、气管-环状软骨或气管-气管端端吻合术,并Ⅰ期行胸骨舌骨肌筋膜瓣转移加强修补食道瘘孔。结果所有患者气管食管瘘均Ⅰ期愈合。5例患者拔除气管套管,呼吸功能恢复良好,仅1例患者未能拔除气管套管。结论对于喉气管狭窄合并气管食管瘘的患者,可以行Ⅰ期气管食管瘘修复并喉气管狭窄切除,根据狭窄部位的不同,采用气管-甲状软骨、气管-环状软骨吻合术或气管-气管端端吻合术,可以取得良好的效果。

Objective To investigate the effect of single-stage surgical treatment of laryngotracheal stenosis complicated with tracheoesophageal fistula. Methods Clinical data of 6 patients underwent surgical treatment of laryngotracheal stenosis complicated with tracheoesophageal fistula in our department from March 2007 to March 2017 were analyzed retrospectively. According to extent and degree of the laryngotraeheal stenosis, thryotracheal, circotrachealor tracheal end-end anastomosis was performed after resection of the lesion. Sternohyoid myofascial flap was adopted for repair of tracheoesophageal fistula simultaneously. Results All patients with tracheoesophageal fistula were cured by single-stage surgery. Five patients were decannulated with good recovery of respiratory function, only one patient failed to remove the tracheostomy tube. Conclusion For laryngotracheal stenosis complicated with tracheoesophageal fistula, favourable therapeutic effect may be obtained via thryotracheal, circotrachealor tracheal end-end anastomosis after lesion resection and simultaneous repair of tracheoesophageal fistula with sternohyoid myofascial flap.