The outcome and techniques of primary and secondary tracheoesophageal puncture.
The outcome and techniques of primary and secondary tracheoesophageal puncture.
复制标题
初次和二次气管食管穿刺的结果和技术。
DOI：
10.1001/archotol.1994.01880270047009
复制
发表时间：
1994
期刊：
影响因子：
--
通讯作者：
C. Silverman
中科院分区：
文献类型：
--
作者：
W. W. Kao;R. Mohr;C. Kimmel;C. Getch;C. Silverman
目标
评估初次和二次气管食管穿刺 (TEP) 的结果，特别是术前和术后放疗对初次 TEP 成功率和并发症发生率的影响，并强调改进的手术和管理技术。
设计
病例系列的回顾性研究。
设置
宾夕法尼亚州费城天普大学健康科学中心医院Chevalier Jackson-Norris 中心耳鼻咽喉科和支气管食管科。
患者
在 8 年的时间里，连续 106 名患者接受了初次 TEP，30 名患者在癌症喉切除术后接受了二次 TEP，以恢复声音，随访时间从 6 个月到 8.5 年不等。接受初次 TEP 的患者组还包括 19 名接受放射治疗和挽救性喉切除术的患者，以及 75 名接受全程术后放疗的患者。
干预
气管食管穿刺和 Blom-Singer 假体。
主要成果指标
言语测量包括 (1) 声音强度、(2) 语调、(3) 持续发声的持续时间和 (4) 语速。
结果
无论是否接受放射治疗，接受初次 TEP 的患者组的成功率均为 93%。接受二次 TEP 的患者成功率达到 83%。没有与 TEP 相关的重大并发症。
结论
强烈建议需要全喉切除术的患者进行初次 TEP，因为可以避免第二次手术并且可以快速获得言语。术后放疗不会增加 TEP 的并发症发生率。
OBJECTIVES
To evaluate the outcome of primary vs secondary tracheoesophageal puncture (TEP), in particular the effects of preoperative and postoperative radiotherapy on success and complication rates in primary TEPs, and to highlight modified surgical and management techniques.
DESIGN
Retrospective study of case series.
SETTING
Chevalier Jackson-Norris Center-Department of Otorhinolaryngology and Bronchoesophagology at Temple University Health Sciences Center Hospital, Philadelphia, Pa.
PATIENTS
One hundred six consecutive patients underwent primary TEPs and 30 underwent secondary TEPs for voice restoration after laryngectomy for cancer over a period of 8 years with follow-ups ranging from 6 months to 8.5 years. The group given primary TEP also includes 19 patients who received radiation for cure and salvage laryngectomy and 75 who received full-course postoperative radiotherapy.
INTERVENTION
Tracheoesophageal puncture and Blom-Singer prosthesis.
MAIN OUTCOME MEASURES
Speech measures including (1) voice intensity, (2) pitch of speech, (3) duration of sustained phonation, and (4) rate of speech.
RESULTS
A success rate of 93% was achieved in the group of patients given primary TEP regardless of radiotherapy. An 83% success rate was achieved with patients given secondary TEP. There were no major complications related to TEPs.
CONCLUSIONS
Primary TEP for patients requiring total laryngectomy is highly recommended since a second operative procedure can be avoided and speech obtained rapidly. Postoperative radiotherapy does not increase the complication rate from TEP.