人喉-气管同种异体移植围手术期经验介绍

Perioperative experience in a case of human laryngotracheal allotransplantation

喉功能丧失是全喉切除术后患者面临的首要问题,虽然目前可以通过某些技术手段(如植入发音钮、使用电子喉等)使喉的发声功能得到部分补偿,通过术后康复训练等改善吞咽功能障碍,但患者仍需终身经气管造瘘口呼吸。喉移植作为目前唯一有可能完全恢复喉功能的治疗措施,一直是国内外耳鼻咽喉头颈外科领域关注的焦点。本文从患者病例介绍、术前评估与准备、手术过程、术后管理4个主要方面回顾四川大学华西医院成功完成的1例人喉-气管同种异体移植术,为今后临床喉移植的发展提供参考。

Loss of laryngeal function is a primary problem faced by patients after total laryngectomy.Although the voice function of the larynx can be partially compensated by some methods(such as implanting a voice prosthesis,using an electrolarynx and so on),and swallowing dysfunction can be improved by postoperative rehabilitation training,patients still need to breathe through the tracheostoma for life.Laryngeal transplantation,as the only therapeutic measure that has the potential to completely restore laryngeal function,has been the focus of attention in the field of otorhinolaryngology head and neck surgery both at home and abroad.In this article,we review a case of human laryngotracheal allotransplantation that was successfully completed in West China Hospital of Sichuan University,including case presentation,preoperative evaluation and preparation,surgical procedure,and postoperative management,which will provide a reference for the future development of clinical laryngeal transplantation.