Piazza Cesare, Del Bon Francesca, Paderno Alberto, Grazioli Paola, Mangili Stefano, Lombardi Davide, Nicolai Piero, Peretti Giorgio
Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
Ann Otol Rhinol Laryngol. 2014 Nov;123(11):798-804. doi: 10.1177/0003489414538764. Epub 2014 Jun 18.
This study aimed to evaluate complications and success rates of tracheal resection and anastomosis (TRA) and cricotracheal resection and anastomosis (CTRA) in patients treated in 2 academic institutions.
Retrospective charts review of 137 patients submitted to TRA/CTRA. Fifty (36.5%) had neoplastic (group A) and 87 (63.5%) benign (group B) stenoses. Using univariate analysis, age, medical comorbidities, previous radiotherapy, type of TRA/CTRA, association with neck dissection and thyroidectomy, length of resected airway, and preoperative tracheotomy were evaluated to identify factors predictive of complications and outcomes.
The mean length of resected airway was 2.7 and 3 cm in groups A and B, respectively. Overall decannulation and complication rates for group A were 96% and 36%, and 99% and 46% for group B, respectively. Length of airway resected and presence of preoperative tracheotomy had a statistically significant effect on major surgical complications. Age older than 70 and cardiovascular and pulmonary comorbidities were significantly associated with the incidence of major medical complications. No statistically significant difference was found considering the complication rates of group A versus group B.
Even though the overall success rate of TRA/CTRA is high, it should always be regarded as a major surgical procedure with a non-negligible incidence of complications.
本研究旨在评估在两家学术机构接受治疗的患者行气管切除吻合术(TRA)和环状气管切除吻合术(CTRA)的并发症及成功率。
对137例行TRA/CTRA手术的患者进行回顾性病历审查。其中50例(36.5%)为肿瘤性狭窄(A组),87例(63.5%)为良性狭窄(B组)。采用单因素分析,评估年龄、内科合并症、既往放疗史、TRA/CTRA类型、是否联合颈部清扫术和甲状腺切除术、切除气道长度以及术前气管切开术,以确定预测并发症和手术结果的因素。
A组和B组切除气道的平均长度分别为2.7 cm和3 cm。A组的总体拔管率和并发症发生率分别为96%和36%,B组分别为99%和46%。切除气道长度和术前气管切开术对主要手术并发症有统计学显著影响。年龄大于70岁以及心血管和肺部合并症与主要内科并发症的发生率显著相关。A组与B组的并发症发生率无统计学显著差异。
尽管TRA/CTRA的总体成功率较高,但它始终应被视为一种主要手术,并发症发生率不可忽视。