気管切開孔閉鎖不全に対する瘻孔閉鎖手術手技の工夫

Improved Surgical Technique for Closing the Tracheocutaneous Fistula

気管切開の後期合併症の一つに気管切開孔閉鎖不全があり，単純な皮膚閉鎖，反転皮弁を用いた閉鎖など，さまざまな外科的治療が報告されている1～4）．しかし，術後の創部離開の頻度は高く，なんらかの治療上の工夫が必要である5）．われわれは，瘻孔周囲皮弁の縫い込みと胸骨舌骨筋を用いた補強を加えた手術により有効に治療しえた気管切開孔閉鎖不全の症例を経験したので報告する．

The tracheocutaneous fistula is a late complication after tracheotomy decannulation, which decreases the quality of life. Though several procedures to close tracheocutaneous fistula were reported, postoperative wound dehiscence was frequently noted. We developed new surgical technique to prevent this complication and report a case in which the technique was successfully applied. This surgical technique is useful simple method to be effective, and safe.