喉頭気管の一期的再建術 (喉頭気管再建術<シンポジウム-2->)

概要

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We devised an operation designed to produce a one stage cure for cases that showed stenosis of the larynx and trachea. 1. The scar tissue of the stenosis area is resected. 2. To reconstruct the inner lining of the lumen, the island pedicle neck flap is inserted. 3. To insure the stable structural framework, the cartilage of the rib is usually used. 4. The stent is inserted into the lumen by using a finger cot, filled with silicon sponge to maintain an adequate airway for about four weeks. 5. The external covering is done by direct closure. 6. The tracheostoma should remain open for four to six months. When this operation is done with special attention given to treatment of the flaps and making the lumen a little wider, it is possible to complete the reconstruction in a short period. In eight cases, all obtained satisfactory results for airway by this method. Recently, "end to end anastomosis"technique is getting to be noteworthy because of a one stage cure. However, if the stenosis exists at glottic level, cur method is better than "end to end anastomosis" from a standpoint of vocal function.
特定非営利活動法人日本気管食道科学会の論文