[Implantation of the T-tube in patients with postintubation tracheal stenosis].
The authors submit an account on their experience with implantation of a Montgomery T-tube in patients with postcannulation stenosis of the trachea. The T-tube was implanted in 10 patients during an 11-year period (1987-1997). In three patients the tube was inserted on account of restenosis which developed after resection of the trachea. In three patients resection treatment was not indicated because of the considerable length of the stenosis (60 mm), in two patients because of the finding of two stenoses at different levels of the trachea, in one patient because of a high stenosis of the trachea with penetrating granulation into the subglottic space and in one patient because of a medical contraindication. The diagnosis of stenosis and its character was based on tomograms of the trachea, bronchoscopy and possibly CT. The T-tube was implanted under general anaesthesia after revision of the tracheal stenosis and if necessary dilatation. The length of the tube always extended over the stenotic portion, in three patients it extended from the bifurcation to the stoma. The T-tube was very well tolerated by the patients and was renewed usually after one year. Only in one patient it proved possible to perform decannulation and close the stoma by a plastic operation using costal cartilage. In the remaining patients the cannula is gradually reduced in length and in some possible decannulation with closure of the stoma in future is assumed. The authors consider the use of a T-tube in some patients with tracheal stenosis a very good therapeutic method which should be used at present in indicated cases.
Fiala
P
P
Klinika pneumologie a hrudní chirurgie 3. LF UK, Praha.
Cermák
J
J
Tobĕrný
M
M
Cernohorský
S
S
Pátek
J
J
D000328:Adult; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015607:Stents; D014135:Tracheal Stenosis / Q000209:etiology / Q000628:therapy*