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使用MLT管的经口激光显微喉手术:一项回顾性病例系列研究

Transoral Laser Microlaryngeal Surgery with MLT Tubes: A Retrospective Case Series.

作者信息

Sarah Umme, Raju Dinesh, Parveen Shehzad, Kudpaje Akshay

机构信息

Fellow in Oncoanaesthesia & Perioperative Medicine, Department of Anaesthesiology, Critical Care and Pain- Cytecare Cancer Hospitals, Bengaluru, India.

Department of Anaesthesiology, Critical Care and Pain- Cytecare Cancer Hospitals, Axon Anaesthesia Associates, Bengaluru, 560064, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):3922-3929. doi: 10.1007/s12070-024-04743-3. Epub 2024 Jun 6.

Abstract

To evaluate effectiveness of using MLT tubes for transoral laser MLS in terms of surgical visualization, complete excision of vocal cord lesions, maintenance of adequate oxygenation and ventilation and the occurrence of any airway related complications. In a retrospective case series study, review of electronic medical records was conducted for 64 patients who underwent transoral laser MLS over an 18-month period. The collected data included vital parameters, mode of ventilation, ET tube details, surgical field of vision, perioperative adverse events and postoperative ventilation requirements. Among the 64 patients, 82.8% of the time, 5 size MLT tubes were used, fixed at mean lengths of 21.6cm in females and 23.07cm in males respectively. A good surgical field of exposure was achieved in 92.2% of patients, with an average FiO2 of 0.29 during laser use and pressure control ventilation mode being the majority choice. 98.4% were extubated on table. The incidence of cuff rupture and bronchospasm was 4.7% and 1.6% respectively with no instances attributable to laser related events. Even though Laser resistant tubes are considered gold standard, MLT tubes can be used by taking adequate precautions to reduce Laser related complications when there is limited availability of laser tubes. Case series.

摘要

评估使用MLT气管导管进行经口激光显微喉镜手术在手术视野、声带病变完全切除、维持充足氧合和通气以及任何气道相关并发症发生方面的有效性。在一项回顾性病例系列研究中,对18个月期间接受经口激光显微喉镜手术的64例患者的电子病历进行了回顾。收集的数据包括生命体征参数、通气模式、气管导管细节、手术视野、围手术期不良事件和术后通气需求。在64例患者中,82.8%的时间使用了5号MLT气管导管,女性平均长度为21.6cm,男性平均长度为23.07cm。92.2%的患者获得了良好的手术暴露视野,激光使用期间平均FiO2为0.29,多数选择压力控制通气模式。98.4%的患者在手术台上拔管。袖带破裂和支气管痉挛的发生率分别为4.7%和1.6%,无激光相关事件导致的病例。尽管抗激光气管导管被认为是金标准,但在激光气管导管供应有限时,采取适当预防措施以减少激光相关并发症,MLT气管导管也可使用。病例系列。

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