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气管及环气管切除吻合术的分类：欧洲喉科学会的提议

Classification of tracheal and crico-tracheal resection and anastomosis: a proposal from the European Laryngological Society.

指南共识咽喉科IF 2.4Q1

文献信息

PMID42969776
原文在 PubMed 查看原文 ↗
发表日期2026
作者Cesare Piazza
查看其他 10 位作者

Giorgio Peretti；Davide Lancini；Kishore Sandu；Marta Filauro；Jan Constantin Koelmel；Francesco Mattioli；Cecilia Molendi；Christoph Arens；Christian Sittel；Reza Nouraei

作者单位Unit of Otorhinolaryngology - Head and Neck Surgery, ASST - Spedali Civili of Brescia, Comprehensive Cancer Center,, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy.
查看其他 6 条单位信息

Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Policlinico San Martino Hospital, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, School of Medicine, Genoa, Italy.；Department of Otorhinolaryngology, University Hospital - CHUV, Lausanne, Switzerland.；Department of Otorhinolaryngology - Head and Neck Surgery, Klinikum Stuttgart, Stuttgart, Germany.；Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Modena, Modena, Italy.；Department of Otorhinolaryngology - Head and Neck Surgery, Medical Faculty, University of Giessen, Giessen, Germany.；The Loxley Centre for Airway, Voice and Swallowing, Department of Otorhinolaryngology, Nottingham University Hospitals NHS Trust, Nottingham, UK.

期刊Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale
SCI 分区Q1
IF2.4
研究类型指南共识 · 临床
所属专科咽喉科

中文摘要

目的： 气管切除吻合术（TRA）和环气管切除吻合术（CTRA）是治疗特定喉气管狭窄病例的高效手术方式，但由于缺乏标准化分类，限制了科学界内通用语言的使用，并阻碍了多中心比较。我们提出欧洲喉科学会（ELS）的提议，主要根据解剖范围及所实施的吻合类型，将（C）TRA分为6种类型（A1、A2、B、C、D和E）。
方法： 该分类通过一个初步的多中心队列进行验证，该队列纳入390例患者，于1996年9月至2026年3月期间在4个欧洲转诊气道中心接受治疗，这些中心共享（C）TRA定义的共同方案。主要结局包括术后并发症和以无气管造口率表示的气道通畅性。
结果： 队列分布于（C）TRA A1型（24.9%）、A2型（21%）、B型（19%）、C型（31%）、D型（1.5%）和E型（2.6%）。总体并发症率和吻合口特异性并发症率从A1型至C型逐渐升高，反映了手术的技术负担，而D型和E型中计划性临时气管切开有效减轻了急性气道并发症。所有（C）TRA类型的长期功能成功率均保持较高水平，所有不同类型（C）TRA手术的无气管造口率为95.1%至100%。
结论： 所提出的ELS分类提供了一个标准化框架，与手术复杂性和并发症特征良好相关，增强了数据可比性，并可作为国际气道领域的宝贵教学资源。

英文摘要

OBJECTIVE: Tracheal (TRA) and crico-tracheal resection and anastomosis (CTRA) are highly effective surgical procedures for managing selected cases of laryngo-tracheal stenosis, although the absence of a standardised classification limits the use of a common language within the scientific community and hinders multicentre comparisons. We present the European Laryngological Society (ELS) proposal, categorising (C)TRA into 6 Types (A1, A2, B, C, D, and E) mainly based on their anatomical extension and type of anastomosis performed.
METHODS: The classification was validated through a preliminary multicentre cohort of 390 patients treated between September 1996 and March 2026 in 4 European referral airway centres sharing a common protocol for definitions of (C)TRA. Primary outcomes included postoperative complications and airway patency in terms of tracheostomy-free rate.
RESULTS: The cohort was distributed across (C)TRA Type A1 (24.9%), A2 (21%), B (19%), C (31%), D (1.5%), and E (2.6%). Overall and anastomosis-specific complication rates increased from Type A1 to Type C, reflecting the technical burden of the procedure, while planned temporary tracheotomy in Types D and E effectively mitigated acute airway morbidity. Long-term functional success remained high across all (C)TRA Types, with tracheostomy-free rates ranging from 95.1% to 100% for all different kinds of (C)TRA procedures.
CONCLUSIONS: The proposed ELS classification provides a standardised framework that correlates well with surgical complexity and complication profiles, enhancing data comparability and serving as a valuable didactic resource for the international airway community.