Rodney Jennifer P, Shinn Justin R, Amin Shaunak N, Portney David S, Mitchell Margaret B, Chopra Zoey, Rees Andrew B, Kupfer Robbi A, Hogikyan Norman D, Casper Keith A, Tate Alan, Vinson Kimberly N, Fletcher Kenneth C, Gelbard Alexander, St Jacques Paul J, Higgins Michael S, Morrison Robert J, Garrett C Gaelyn
Department of Otolaryngology-Head and Neck Surgery, The Ear, Nose, Throat and Plastic Surgery Associates, Orlando, Florida, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Laryngoscope. 2021 Oct;131(10):2292-2297. doi: 10.1002/lary.29431. Epub 2021 Feb 20.
OBJECTIVES/HYPOTHESIS: To evaluate the safety and complications of endoscopic airway surgery using supraglottic jet ventilation with a team-based approach.
Retrospective cohort study.
Subjects at two academic institutions diagnosed with laryngotracheal stenosis who underwent endoscopic airway surgery with jet ventilation between January 2008 and December 2018 were identified. Patient characteristics (age, gender, race, follow-up duration) and comorbidities were extracted from the electronic health record. Records were reviewed for treatment approach, intraoperative data, and complications (intraoperative, acute postoperative, and delayed postoperative).
Eight hundred and ninety-four patient encounters from 371 patients were identified. Intraoperative complications (unplanned tracheotomy, profound or severe hypoxic events, barotrauma, laryngospasm) occurred in fewer than 1% of patient encounters. Acute postoperative complications (postoperative recovery unit [PACU] rapid response, PACU intubation, return to the emergency department [ED] within 24 hours of surgery) were rare, occurring in fewer than 3% of patient encounters. Delayed postoperative complications (return to the ED or admission for respiratory complaints within 30 days of surgery) occurred in fewer than 1% of patient encounters. Diabetes mellitus, active smoking, and history of previous tracheotomy were independently associated with intraoperative, acute, and delayed complications.
Employing a team-based approach, jet ventilation during endoscopic airway surgery demonstrates a low rate of complications and provides for safe and successful surgery.
4 Laryngoscope, 131:2292-2297, 2021.
目的/假设：采用团队协作方法，评估声门上喷射通气在内镜气道手术中的安全性及并发症。
回顾性队列研究。
确定2008年1月至2018年12月期间在两家学术机构被诊断为喉气管狭窄并接受喷射通气内镜气道手术的患者。从电子健康记录中提取患者特征（年龄、性别、种族、随访时间）及合并症。审查记录以获取治疗方法、术中数据及并发症（术中、术后急性和术后延迟）情况。
共识别出371例患者的894次就诊情况。术中并发症（计划外气管切开、严重或极重度缺氧事件、气压伤、喉痉挛）发生率低于1%。术后急性并发症（术后恢复室[PACU]快速反应、PACU插管、术后24小时内返回急诊科[ED]）罕见，发生率低于3%。术后延迟并发症（术后30天内因呼吸问题返回ED或入院）发生率低于1%。糖尿病、当前吸烟及既往气管切开史与术中、急性和延迟并发症独立相关。
采用团队协作方法，内镜气道手术中的喷射通气并发症发生率低，手术安全且成功。
4 喉镜，131:2292 - 2297，2021年。
