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蜻蜓技术在临时气管切开术中的气管关闭。手术步骤和临床结果。

The dragonfly technique for trachea closure in temporary tracheostomies. Surgical steps and clinical results.

机构信息

ENT Department, Annunziata Hospital, Cosenza, SS, Italy.

Interventional Radiology, Annunziata Hospital, Cosenza, SS, Italy.

出版信息

Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5947-5953. doi: 10.1007/s00405-024-08821-8. Epub 2024 Jul 13.

Abstract

PURPOSE

To assess the effectiveness of a new suturing technique called Dragonfly for the closure of temporary tracheotomies. This technique involves placing two sutures during the tracheotomy procedure and leaving them loose and unknotted until the day of skin closure.

METHODS

Retrospective case control study. Monocentric study at a department of Otolaryngology and head and neck surgery at a tertiary centre in Italy. A total of 50 patients who underwent temporary tracheotomy between January 2017 and December 2021. Patients were divided into two groups based on the trachea closure method: traditional closure with sutures placed during the skin closure procedure (Group A) and the Dragonfly technique (Group B). The incidence of tracheal stenosis by Computed Tomography (CT), granulation tissue formation, bleeding, procedure duration, patient discomfort were evaluated.

RESULTS

The incidence of tracheal complications and tracheal stenosis was reduced in Group B (6%) compared to Group A (24%). Procedure times (3 min vs. 6 min) durations was significantly shorter. No patients had symptoms of tracheal stenosis at the end of the procedures.

CONCLUSION

The Dragonfly suturing technique is effective and safe for tracheotomy closure, reducing the incidence of tracheal stenosis and shortening hospitalization duration compared to the traditional method.

摘要

目的

评估一种名为蜻蜓(Dragonfly)的新型缝合技术在临时气管切开术闭合中的效果。该技术在气管切开术中放置两条缝线,并使其保持松弛和未打结状态,直到皮肤闭合的那一天。

方法

回顾性病例对照研究。在意大利一家三级中心的耳鼻喉头颈外科进行的单中心研究。共纳入 2017 年 1 月至 2021 年 12 月期间接受临时气管切开术的 50 例患者。根据气管闭合方法将患者分为两组:在皮肤闭合过程中放置缝线的传统闭合(A 组)和蜻蜓技术(B 组)。通过计算机断层扫描(CT)评估气管狭窄、肉芽组织形成、出血、手术时间、患者不适等发生率。

结果

与 A 组(24%)相比,B 组(6%)的气管并发症和气管狭窄发生率降低。手术时间(3 分钟对 6 分钟)明显缩短。在手术结束时,没有患者出现气管狭窄的症状。

结论

与传统方法相比,蜻蜓缝合技术在气管切开术闭合中是有效且安全的,可降低气管狭窄的发生率并缩短住院时间。

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