Bobby R. Alford Department of Otolaryngology Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
Department of Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.
Laryngoscope. 2024 Jun;134(6):2941-2944. doi: 10.1002/lary.31271. Epub 2024 Jan 24.
The purpose of this study is to determine whether tracheostomy stomal maturation affects the risk of tracheocutaneous fistula (TCF) in children.
A retrospective chart review was conducted for all children who both underwent a tracheostomy and were decannulated between 2012 and 2021 at a tertiary children's hospital. Charts were analyzed for demographics, surgical technique, and development of a TCF. TCF was defined as a persistent fistula following 3 months after decannulation.
179 children met inclusion criteria. The median (interquartile range) age at tracheostomy was 1.5 (82.4) months, average (standard deviation [SD]) duration of tracheotomy was 20.0 (20.6) months, and length of follow-up after decannulation (range; SD) was 39.3 (4.4-110.0; 26.7) months. 107 patients (60.0%) underwent stomal maturation and 98 patients developed a TCF (54.7%). Younger age at tracheostomy placement was significantly associated with increased risk of TCF, mean (SD) age 28.4 (51.4) version 80.1 (77.5) months (p < 0.001). Increased duration of tracheostomy was significantly associated with increased risk of TCF, 27.5 (18.4) version 11.0 (18.2) months (p < 0.001). Stomal maturation was not significantly associated with the risk of TCF, including on multivariable analysis adjusting for age at tracheostomy and duration of tracheostomy (p = 0.089).
Tracheostomy stomal maturation did not affect the risk of TCF in children, even after adjusting for age and duration of tracheostomy.
4 Laryngoscope, 134:2941-2944, 2024.
本研究旨在确定气管造口瘘（TCF）在儿童中发生的风险是否与气管造口管腔成熟有关。
对 2012 年至 2021 年间在一家三级儿童医院接受气管造口术并拔管的所有儿童进行回顾性图表审查。对图表进行了分析，以了解人口统计学、手术技术以及 TCF 的发展情况。定义 TCF 为拔管后 3 个月仍存在持续瘘管。
179 名儿童符合纳入标准。气管造口术时的中位（四分位间距）年龄为 1.5（82.4）个月，平均（标准差[SD]）气管切开术持续时间为 20.0（20.6）个月，拔管后随访时间（范围；SD）为 39.3（4.4-110.0；26.7）个月。107 名患者（60.0%）接受了管腔成熟治疗，98 名患者发生 TCF（54.7%）。气管造口术放置时的年龄越小，TCF 的风险越高，平均（SD）年龄 28.4（51.4）岁，版本 80.1（77.5）个月（p<0.001）。气管切开术持续时间越长，TCF 的风险越高，27.5（18.4）岁，版本 11.0（18.2）个月（p<0.001）。管腔成熟与 TCF 的风险无显著相关性，包括在调整气管造口术时年龄和气管切开术持续时间的多变量分析中（p=0.089）。
即使在调整了气管造口术时的年龄和气管切开术持续时间后，气管造口瘘管腔成熟也不会影响儿童 TCF 的风险。
4 Laryngoscope，134：2941-2944，2024.
