Burçin ÇELİK, Ekber ŞAHİN, Aydın NADİR, Sulhattin ARSLAN, Şinasi MANDUZ, Şule KARADAYI, Melih KAPTANOĞLU

Trakea stenozlarında tedavi yaklaşımları: On beş olgunun analizi

Amaç: Bu çalışmada, trakea stenozu nedeniyle tedavi edilen hastaların klinik sonuçları incelendi.Çalışma planı: Haziran 1992 ile Ekim 2008 arasında kliniğimizde trakea stenozu tedavisi yapılan 15 hastanın (6 erkek, 9 kadın; ort. yaş 39.2±23.2 yıl; dağılım 8-70 yıl) klinik kayıtları geriye dönük incelendi. Tanı yöntemleri, trakeal stenozun yerleşim yeri, tedavi yaklaşımları ve tanısal sonuçları açısından değerlendirildi.Bulgular: Altı hastada trakeostomi, beş hastada uzamış entübasyon zamanı, dört hastada ise malignite nedeniyle trakeal darlık gelişmiş idi. En sık kullanılan tanı aracı rijit bronkoskopi idi. Sekiz hasta konservatif yöntemler ile tedavi edildi. Dokuz hastada ilk tedavi seçeneği olarak diatermik rezeksiyon uygulandı. Yedi hastaya rezeksiyon ve uç-uca anastomoz, altı hastaya ise trakea stenti uygulandı. Üç hastada 12 ile 18 ay arasında stentler çıkarıldı. Ortalama hastanede kalış süresi 12 gün idi. Morbidite dört hastada, mortalite ise üç hastada görüldü.Sonuç: Trakea stenozlarında başarı oranı, cerrahi yöntemlerle tedavi edilenlerde %71-97, konservatif yöntemlerle tedavi edilenlerde ise %65-70 idi. Cerrahi seçenekler ilk olarak düşünülmeli fakat konservatif yöntemler de akılda tutulmalıdır.

Therapeutic approaches in tracheal stenosis: Analysis of fifteen cases

Background: In this study, results of treatment of patients who had tracheal stenosis were evaluated.Methods: The clinical records of 15 patients (6 males, 9 females; mean age 39±23.2 years; range 8 to 70 years) who were treated for tracheal stenosis between June 1992 and October 2008 were analyzed retrospectively. The diagnostic method, localization, therapeutic approach and results of tracheal stenosis were investigated.Results: Tracheal stenosis was due to tracheostomy in six, prolonged intubation in five and malignancy in four patients. Rigid bronchoscopy was the most frequent diagnostic tool. Eight patients were treated conservatively. Diathermic resection was the first treatment of choice in nine patients. Resection and end-to-end anastomosis was used in seven patients and tracheal stent was used in six patients. Stents of three patients were removed within 12 to 18 months. Median duration of hospitalization was 12 days. Morbidity was seen in four patients; mortality was seen in three patients.Conclusion: The success rate in tracheal stenosis treated by surgery is 71 to 97% and it is 65 to 70% by conservative methods. Surgical options should be considered first, but conservative methods should keep in mind.

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