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Titolo:
Multidisciplinary approach to management of postintubation tracheal stenoses
Autore:
Brichet, A; Verkindre, C; Dupont, J; Carlier, ML; Darras, J; Wurtz, A; Ramon, P; Marquette, CH;
Indirizzi:
CtrFranceReg & Univ Lille, Hop A Calmette, Clin Malad Resp, F-59037 Lille,Ctr Hosp Reg & Univ Lille Lille France F-59037 alad Resp, F-59037 Lille, Ctrle,sp Reg & Univ Lille, Hop A Calmette, Serv Chirurg Thorac, F-59037 Lil Ctr Hosp Reg & Univ Lille Lille France F-59037 irurg Thorac, F-59037 Lil CtrLille,Reg & Univ Lille, Hop C Huriez, Dept Anesthesie Reanimat, F-59037Ctr Hosp Reg & Univ Lille Lille France F-59037 sthesie Reanimat, F-59037 Ctrle,sp Reg & Univ Lille, Hop C Huriez, Serv Otorhinolaryngol, F-59037 Lil Ctr Hosp Reg & Univ Lille Lille France F-59037 hinolaryngol, F-59037 Lil
Titolo Testata:
EUROPEAN RESPIRATORY JOURNAL
fascicolo: 4, volume: 13, anno: 1999,
pagine: 888 - 893
SICI:
0903-1936(199904)13:4<888:MATMOP>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRACHEOBRONCHIAL STENOSES; ENDOSCOPIC TREATMENT; SUBGLOTTIC STENOSIS; SILICONE STENTS; COMPLICATIONS; LASER; TRACHEOSTOMY; INTUBATION; RESECTION; DILATION;
Keywords:
bronchoscopy; stenoses; stents; surgery tracheal; YAG laser;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Marquette, CH Ctr037sp Reg & Univ Lille, Hop A Calmette, Clin Malad Resp, Pl Verdun, F-59 Ctr Hosp Reg & Univ Lille Pl Verdun Lille France F-59037 59
Citazione:
A. Brichet et al., "Multidisciplinary approach to management of postintubation tracheal stenoses", EUR RESP J, 13(4), 1999, pp. 888-893

Abstract

The optimal management of postintubation tracheal stenosis is not well defined,A therapeutic algorithm was designed by thoracic surgeons, ear, nose and throat (ENT) surgeons, anaesthetists and pulmonologists, Rigid bronchoscopy with neodymium-yttrium aluminium garnet (Nd-YAG) laser resection or stent implantation (removable stent) was proposed as first-line treatment, depending on the type of stenosis (web-like versus complex stenosis), In patients with web-Like stenoses, sleeve resection was proposed when laser treatment (up to three sessions) failed. In patients with complex stenoses, operability was assessed 6 months after stent implantation. If the patient was judged operable, the stent was removed and the patient underwent surgery if the stenosis recurred. This algorithm was validated prospectively in a series of 32 consecutive patients. Three patients died from severe coexistent illness shortly after the first bronchoscopy. Of the 15 patients with web-like stenosis, laser resection was curative in 10 (66%). Among the 17 patients with complex stenoses, three remained symptom-free after stent removal. Bronchoscopy alone was thus curative in more than one-third of the patients. Six patients underwent surgery, two after failure of laser resection and four after failure of temporary stenting, Surgery was always performed with the patient in good operative condition. Palliative stenting was the definitive treatment in ninecases. Tracheostomy was the definitive solution in two cases. This approach, including an initial conservative treatment, depending on the type of the stenosis, appears to be applicable to almost all patients and allows secondary surgery to be performed with the patient in good condition.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 15:33:02