喉及颈胸段气管切除无名动脉下方纵隔气管造口术在气管外科中的应用  

Application of medicastinal tracheostomy below innominate artery in tracheal surgery when larynx and thoracocervical trachea were excised

作　　者：段德溥[1] 张绍明[1] 任犹俊 杨可贤 信德和[1] 张珩[1] 才志刚[1] 吴胜勇[1] 李玉萍[1] 

机构地区：[1]中国人民解放军第四五五医院胸心外科,上海200052

出　　处：《中国癌症杂志》2000年第5期388-390,共3页China Oncology

摘　　要：目的 :探讨与研究低位胸段气管纵隔造口术的适应征、手术技术难点以及在气管外科治疗中的价值。方法 :对 1例肿瘤长度 5 6cm的颈胸段气管癌患者设计采用了前上胸壁大块切除、右胸大肌皮瓣的建立与转移 ,带血管蒂大网膜经胸骨后间隙填塞气管造口周围以及低位胸段气管造口端转至无名动脉下方等多种手术步骤 ,最终完成喉及颈胸段气管切除 ,无名动脉下方纵隔气管造口术。结果 :切口基本一期愈合 ,手术获得成功。随访一年 ,未出现无名动脉磨损性破裂出血等并发症。结论 :对颈胸段气管癌切除后所保留的低位胸段气管长度不足 5 0cm情况下 。Purpose:Discuss and study indication of inferior thoracal tracheostomy, technical difficulty of the operation, and its value of treatment in tracheal surgery.Methods:In the treatment of a patient with thoracocervical tracheocarcinoma (5.6 cm long),excision of larynx and thoracocervical trachea as well as mediastinal tracheostomy below innominate artery were successfully achieved after the following steps of operaton:massive removal of chest wall of ante superior mediastinum, construction and transfer of skin petal of right pectoralis major muscle, tamping of omentum majus with the base of blood vessel about the mouth of incised trachea through posterior place of sternum, and transfer of the inferior end of incised trachea to below the innominate artery.Results:Healing by first intention of the incision was achieved with a successful operation. During the following year of visiting the patient, such complications as wear and tear rupture and hemorrhage of innominate artery was not found in the patient.Conclusions:In the circumstances that the reserved inferior trachea of chest is less than 5 cm long after excision of thoracocervical tracheocarcinoma, it is ideal to apply mediastinal tracheostomy below innominate artery.

关 键 词：气管肿瘤 喉管切除 气管切除 纵隔气管造口 

分 类 号：R734.105[医药卫生—肿瘤] R730.56[医药卫生—临床医学]