Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Department of Thoracic Surgery, Sapienza University of Rome, Rome, Italy.
Eur J Cardiothorac Surg. 2024 Mar 29;65(4). doi: 10.1093/ejcts/ezae084.
Compared to lung resections, airway procedures are relatively rare in thoracic surgery. Despite this, a growing number of dedicated airway centres have formed throughout Europe. These centres are characterized by a close interdisciplinary collaboration and they often act as supra-regional referring centres. To date, most evidence of airway surgery comes from retrospective, single-centre analysis as there is a lack of large-scale, multi-institutional databases.
In 2018, an initiative was formed, which aimed to create an airway database within the framework of the ESTS database (ESTS-AIR). Five dedicated airway centres were asked to test the database in a pilot phase. A 1st descriptive analysis of ESTS-AIR was performed.
A total of 415 cases were included in the analysis. For adults, the most common indication for airway surgery was post-tracheostomy stenosis and idiopathic subglottic stenosis; in children, most resections/reconstructions had to be performed for post-intubation stenosis. Malignant indications required significantly longer resections [36.0 (21.4-50.6) mm] when compared to benign indications [26.6 (9.4-43.8) mm]. Length of hospital stay was 11.0 (4.1-17.3) days (adults) and 13.4 (7.6-19.6) days (children). Overall, the rates of complications were low with wound infections being reported as the most common morbidity.
This evaluation of the 1st cases in the ESTS-AIR database allowed a large-scale analysis of the practice of airway surgery in dedicated European airway centres. It provides proof for the functionality of ESTS-AIR and sets the basis for rolling out the AIR subsection to all centres participating in the ESTS database.
与肺切除术相比，气道手术在胸外科中相对较少见。尽管如此，全欧洲还是成立了越来越多的专门气道中心。这些中心的特点是密切的跨学科合作，并且它们通常充当超区域转诊中心。迄今为止，气道手术的大部分证据来自回顾性的单中心分析，因为缺乏大规模的多机构数据库。
2018 年，成立了一项倡议，旨在在 ESTS 数据库（ESTS-AIR）的框架内创建一个气道数据库。要求五个专门的气道中心在试点阶段测试该数据库。对 ESTS-AIR 进行了第 1 次描述性分析。
共纳入 415 例病例进行分析。对于成人，气道手术最常见的适应证是气管切开术后狭窄和特发性声门下狭窄；对于儿童，大多数切除/重建是因为气管插管后狭窄。恶性适应证的切除长度明显长于良性适应证[36.0（21.4-50.6）mm 比 26.6（9.4-43.8）mm]。住院时间为 11.0（4.1-17.3）天（成人）和 13.4（7.6-19.6）天（儿童）。总体而言，并发症发生率较低，以伤口感染为最常见的发病率。
ESTS-AIR 数据库中首批病例的评估允许对专门的欧洲气道中心的气道手术实践进行大规模分析。它证明了 ESTS-AIR 的功能，并为向所有参与 ESTS 数据库的中心推出 AIR 子部分奠定了基础。
