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小儿喉气管重建术中肋软骨取材相关并发症

Complications associated with costal cartilage harvest in pediatric laryngotracheal reconstruction.

作者信息

Lava Christian X, Martin Taylor S, Leonard James A, Blumenthal Daniel L, Scriven-Weiner Kelly, Chu Eugenia, Harley Earl H

机构信息

Georgetown University School of Medicine Washington DC USA.

MedStar Georgetown University Hospital Department of Otolaryngology - Head and Neck Surgery Washington DC USA.

出版信息

Laryngoscope Investig Otolaryngol. 2023 Feb 28;8(2):584-590. doi: 10.1002/lio2.1028. eCollection 2023 Apr.

Abstract

OBJECTIVE

We aimed to determine the rate of complications associated with autologous costal cartilage graft harvest for pediatric laryngotracheal reconstruction (LTR). Secondarily, we sought to identify risk factors associated with the harvest of autologous costal cartilage, as well as evaluate management strategies.

DATA SOURCES

An electronic database search of Ovid MEDLINE, Ovid EMBASE, and PubMed was completed for articles pertaining to complications in autologous costal cartilage harvest for pediatric LTR.

REVIEW METHODS

This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The study characteristics, operative information, and patient demographics were collected. The data concerning postoperative complications, risk factors, and management strategies were collected and analyzed for patterns.

RESULTS

A total of 31 manuscripts representing 745 patients were included for analysis. The reported donor site complications included pneumothorax ( = 13, 1.74%), pleural tear ( = 5, 0.67%), infection ( = 8, 1.07%), and scar-related problems ( = 2, 0.26%). There were no reported cases of seroma, persistent pain, or chest wall deformity. Only five studies discussed the management of donor site complications, with intervention in 11 (39.28%) patients including chest tube drainage and steroid injection.

CONCLUSION

There is significant variability in the literature regarding complication rates in autologous costal cartilage harvest for pediatric LTR. The incidence of major postoperative complications is low and supports the use of autologous costal cartilage as graft material for pediatric LTR.

LEVEL OF EVIDENCE

NA.

摘要

目的

我们旨在确定小儿喉气管重建术(LTR)中自体肋软骨移植取材相关并发症的发生率。其次,我们试图找出与自体肋软骨取材相关的危险因素,并评估管理策略。

数据来源

对Ovid MEDLINE、Ovid EMBASE和PubMed电子数据库进行检索,以查找有关小儿LTR自体肋软骨取材并发症的文章。

综述方法

本系统综述遵循系统评价和Meta分析的首选报告项目(PRISMA)2020指南。收集研究特征、手术信息和患者人口统计学资料。收集并分析有关术后并发症、危险因素和管理策略的数据,以找出规律。

结果

共纳入31篇文献,涉及745例患者进行分析。报告的供区并发症包括气胸(n = 13,1.74%)、胸膜撕裂(n = 5,0.67%)、感染(n = 8,1.07%)和瘢痕相关问题(n = 2,0.26%)。未报告有血清肿、持续性疼痛或胸壁畸形的病例。只有五项研究讨论了供区并发症的管理,11例(39.28%)患者接受了干预,包括胸腔闭式引流和类固醇注射。

结论

关于小儿LTR自体肋软骨取材并发症发生率的文献报道差异很大。术后主要并发症的发生率较低,支持将自体肋软骨用作小儿LTR的移植材料。

证据级别

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94d0/10116967/210b64d67b9e/LIO2-8-584-g001.jpg

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