Eyassu Daniel G, Candelo Estephania, Asgedom Brhanu H, Wallerius Katherine P, Twardus Shaina W, Niermeyer Weston L, Green Katerina J, Athni Tejas S, Wiedermann Joshua P
Department of Otolaryngology and Head and Neck Surgery Mayo Clinic Rochester Minnesota USA.
Department of Otolaryngology and Head and Neck Surgery University of Washington School of Medicine Seattle Washington USA.
Laryngoscope Investig Otolaryngol. 2024 Nov 17;9(6):e70034. doi: 10.1002/lio2.70034. eCollection 2024 Dec.
This study aims to document and analyze the challenges and outcomes of performing complex airway surgery in a low-resource, post-war setting in Mekelle, Ethiopia.
This prospective case series examines clinical data from five patients who underwent airway reconstruction surgeries and one patient who underwent total laryngectomy at Ayder Comprehensive Specialized Hospital in Mekelle. Data included patient demographics, airway stenosis etiology and severity, operative details, postoperative outcomes, complications, and hospital length of stay. Ethical approval was obtained from institutional review boards at Mayo Clinic and Mekelle University.
The study included six patients aged 9-62 years, with surgeries comprising three cricotracheal resections, two tracheal resections, and one laryngectomy. Three reconstructions were for war-related injuries. Challenges included power outages during surgeries, limitations in medical supplies and equipment, and inadequate perioperative care. Despite these, three patients requiring tracheostomies were successfully decannulated within a year. However, complications such as restenosis, infections, and the need for reintubation were common.
Airway surgeries in a low-resource, post-war setting face significant hurdles, including perioperative care quality, resource limitations, and infrastructure issues. Successful outcomes require multidisciplinary training tailored to local contexts, investments in hospital infrastructure and reliable electricity, and proper perioperative nutrition. This study highlights the need for comprehensive interventions to improve surgical care in such settings. IV.
本研究旨在记录和分析在埃塞俄比亚默克莱资源匮乏的战后环境中进行复杂气道手术的挑战及结果。
本前瞻性病例系列研究考察了在默克莱的艾德尔综合专科医院接受气道重建手术的5例患者以及接受全喉切除术的1例患者的临床数据。数据包括患者人口统计学信息、气道狭窄的病因和严重程度、手术细节、术后结果、并发症及住院时间。获得了梅奥诊所和默克莱大学机构审查委员会的伦理批准。
该研究纳入了6例年龄在9至62岁之间的患者，手术包括3例环状气管切除术、2例气管切除术和1例喉切除术。3例重建手术是针对与战争相关的损伤。挑战包括手术期间停电、医疗用品和设备的限制以及围手术期护理不足。尽管如此，3例需要气管切开术的患者在一年内成功拔管。然而，再狭窄、感染以及再次插管的需求等并发症很常见。
在资源匮乏的战后环境中进行气道手术面临重大障碍，包括围手术期护理质量、资源限制和基础设施问题。成功的结果需要针对当地情况进行多学科培训、对医院基础设施和可靠电力进行投资以及适当的围手术期营养。本研究强调了在这种环境下改善手术护理需要全面干预措施。 四、
