插管后气管狭窄手术治疗的长期效果:气管切除和重建的回顾性分析。

IF 2.4 3区 医学 Q2 SURGERY Updates in Surgery Pub Date : 2024-11-23 DOI:10.1007/s13304-024-02040-w
Ahmet Ulusan, Ibrahim Emre Tunca, Bekir Elma, Maruf Sanli, Ahmet Feridun Isik
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引用次数: 0

摘要

插管后气管狭窄(PITS)是长期插管的一种严重并发症,通常需要手术干预。本研究旨在介绍接受气管切除和重建术的 PITS 患者的长期疗效,并讨论这些手术方法与支架植入术的疗效对比。这项回顾性研究纳入了2005年10月至2022年10月期间在本中心接受治疗的PITS患者。患者分为两组:接受气管切除和重建术的患者(29 人)和接受支架植入术的患者(47 人)。对患者的临床特征、手术技术、并发症和长期疗效进行了记录和分析。患者的平均年龄为41.3岁,其中40.0%的患者年龄在40至60岁之间。平均插管时间为 16.8 天。在切除组中,29 位患者中有 22 位(75.8%)在长期随访中没有出现复发或并发症。手术治疗的总体成功率为 93.1%,死亡率为 6.8%。在支架植入组,47 例患者中有 9 例成功移除支架,平均移除时间为 26 个月。与接受手术治疗的患者相比,支架植入患者更容易出现肉芽组织形成和再狭窄。气管切除术和端对端吻合术仍是治疗 PITS 的金标准,与支架植入术相比,其复发率更低,长期并发症更少。不过,对于不适合手术的患者来说,支架植入术也不失为一种可行的选择。仔细的术前评估和长期随访对优化患者预后至关重要。
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Long-term outcomes of surgical management in post-intubation tracheal stenosis: a retrospective analysis of tracheal resection and reconstruction.

Post-intubation tracheal stenosis (PITS) is a serious complication of prolonged intubation, often requiring surgical intervention. This study aims to present the long-term outcomes of patients with PITS who underwent tracheal resection and reconstruction, as well as to discuss the efficacy of these surgical methods in comparison to stenting. This retrospective study included patients treated for PITS at our center between October 2005 and October 2022. Patients were divided into two groups: those who underwent tracheal resection and reconstruction (n = 29) and those treated with stenting (n = 47). The clinical characteristics, surgical techniques, complications, and long-term outcomes were recorded and analyzed. The mean age of the patients was 41.3 years, with 40.0% aged between 40 and 60 years. The mean intubation duration was 16.8 days. In the resection group, 22 of 29 patients (75.8%) showed no recurrence or complications during long-term follow-up. The overall success rate for surgical treatment was 93.1%, with a mortality rate of 6.8%. In the stenting group, successful stent removal was achieved in 9 of 47 cases, with a mean stent removal time of 26 months. Granulation tissue formation and restenosis were more frequently observed in stented patients compared to those who underwent surgery. Tracheal resection and end-to-end anastomosis remain the gold standard treatment for PITS, with a lower recurrence rate and fewer long-term complications compared to stenting. However, stenting may be a viable option for patients who are not suitable candidates for surgery. Careful preoperative evaluation and long-term follow-up are essential to optimize patient outcomes.

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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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