[用硅胶内支架治疗卡他性气管狭窄的非标准长期气管支架术]。

Q4 Medicine Khirurgiya Pub Date : 2024-01-01 DOI:10.17116/hirurgia202408169
V D Parshin, E B Nikolaeva, M A Rusakov, F A Chernousov, S A Khachatryan
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引用次数: 0

摘要

内窥镜下重新封堵和支架植入术是治疗卡他性气管狭窄的方法之一。如果不注意支架的使用寿命,可能会出现重大并发症。然而,目前还没有明确的支架植入时机。在世界范围内,尚无针对卡他性气管狭窄的终生支架植入适应症。支架移除后出现再狭窄的情况更为常见,需要重复支架置入或采用其他治疗方法。在长期支架植入的情况下,由于硅橡胶的破坏,硅胶支架应定期更换为类似的支架。一般来说,1-3 年后就需要进行这种操作。目前,还没有关于不更换支架的最长允许持续时间以及可能出现的并发症的信息。长期支架置入后气管的状况也不得而知。我们介绍了长期(27 年)使用硅胶支架进行气管支架置入术的情况。在此期间,支架碎裂和脱位导致呼吸衰竭并被紧急取出。术后气管腔立即恢复良好。然而,1 个半月后出现了气管再狭窄,需要进行内窥镜扩张并讨论适当的治疗方案。然而,患者拒绝切除气管并进行吻合术,而是再次使用类似的支架进行了支架植入术,并立即取得了良好的效果。
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[Non-standard long-term tracheal stenting with silicone endoprosthesis for cicatricial stenosis].

Endoscopic approach with recanalization and stenting is one of the methods for cicatricial tracheal stenosis. Major complications may occur if service life of stents is not observed. However, there are currently no clear timing for stenting. In world practice, there are no indications on lifelong stenting for cicatricial tracheal stenosis. Restenosis is more common after stent removal and requires repeated stenting or another treatment. In case of prolonged stenting, silicone stent should be periodically replaced with a similar one due to destruction of silicone rubber. As a rule, this maneuver is necessary after 1-3 years. Currently, there is no information about maximum allowable duration of stent without replacement and possible complications. Condition of trachea after prolonged stenting is also unknown. We present long-term (27 years) tracheal stenting with a silicone stent. Stent fragmentation and dislocation throughout this period led to respiratory failure and emergency removal. Tracheal lumen was satisfactory immediately after procedure. However, restenosis appeared after 1.5 months and required endoscopic dilation with discussion of appropriate treatment option. However, the patient refused tracheal resection with anastomosis and underwent repeated stenting with similar stent and favorable immediate result.

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来源期刊
Khirurgiya
Khirurgiya Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
161
期刊介绍: Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень
期刊最新文献
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