Gelfand Yuri M, Duncan Newton O, Albright James T, Roy Soham, Montagnino Barbara, Edmonds Joseph L
University of Texas at Houston Medical School, Department of Otorhinolaryngology, 6431 Fannin Street, Suite 5.036, Houston, TX 77030, United States.
Int J Pediatr Otorhinolaryngol. 2011 Jul;75(7):931-4. doi: 10.1016/j.ijporl.2011.04.008. Epub 2011 May 12.
Laryngotracheal separation surgery (LTS) was performed as a treatment for recurrent or intractable aspiration pneumonia in 12 pediatric patients. The effectiveness of LTS surgery for preventing aspiration pneumonia, and the complications of this procedure were investigated.
A retrospective chart review, conducted at a tertiary academic hospital in conjunction with a private practice, was used to identify children who underwent Laryngotracheal Separation Surgery (LTS) from September 2001 to July 2007. The main outcome measure was the number of hospital admissions for pneumonia in the pre LTS and post LTS period. A student's t-test was used for statistical analysis.
LTS surgery decreased the frequency of pulmonary infections and respiratory events in all patients, resulting in far fewer hospitalizations. These patients experienced an average of 5 hospital admissions for pneumonia in the 2 years prior to LTS surgery, and an average of 1.1 hospital admissions for pneumonia after the LTS surgery. There were no major complications related to the surgery. Several minor complications following surgery were easily and effectively dealt with in the perioperative period.
LTS surgery is an effective and safe procedure in children with intractable aspiration. Parents do not perceive the care of the LTS stoma as burdensome. This procedure should be considered as an option in the surgical intervention for the management of chronic aspiration pneumonia in severely neurologically impaired children.
对12例儿科患者实施喉气管分离手术（LTS），以治疗复发性或难治性吸入性肺炎。研究LTS手术预防吸入性肺炎的有效性及该手术的并发症。
在一家三级学术医院结合一家私人诊所进行回顾性病历审查，以确定2001年9月至2007年7月期间接受喉气管分离手术（LTS）的儿童。主要观察指标是LTS手术前和手术后因肺炎住院的次数。采用学生t检验进行统计分析。
LTS手术降低了所有患者肺部感染和呼吸事件的发生率，住院次数大幅减少。这些患者在LTS手术前两年因肺炎平均住院5次，LTS手术后因肺炎平均住院1.1次。没有与手术相关的重大并发症。术后的一些轻微并发症在围手术期得到了轻松有效的处理。
LTS手术对于难治性误吸患儿是一种有效且安全的手术。家长并不认为护理LTS造口是一项负担。该手术应被视为严重神经功能受损儿童慢性吸入性肺炎手术干预的一种选择。
