数度のT-tube療法が奏効せず困難を極めた気管端々吻合術

抄録

Department of Otolaryngology, The Jikei University School of Medicine The authors report a case where anastomosis of the trachea succeeded after many difficult trials. A 40-year-old male developed stenosis of the trachea due to granulation proliferation at the end of a tracheal cannula. The granulation had to be removed frequently, which each time was followed by a placement of a stent. Local granulation however, could not be controlled and the stenosis recurred invariably after every procedure. Four tracheal cartilages from no. 2 to no. 5 or 4 cm in length were then excised and was followed by end to end anastomosis. But the scar tissues and adhesions with the surrounding tissues again separated the two ends. The anastomosis finally succeeded after using the laryngeal release by the methods after Montgomery and Dedo-Fishman together with separation of the pharyngeal sphinctors.
The postoperative course has been uneventful except mild limitation in extension of the neck and lack of smoothness in swallowing.