Li Bo, Dong Jie, Zou Chanjuan, Zhao Fan, Ma Tidong, Zhou Chonggao
Neonatal Surgery, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Hunan, 410007, Changsha, China.
Pediatric Research Department, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Hunan, 410007, Changsha, China.
Pediatr Surg Int. 2025 Jun 23;41(1):186. doi: 10.1007/s00383-025-06083-x.
To examine the consequences of preoperative invasive ventilation (IV), postoperative IV and reintubation on the occurrence of ES in type C CEA patients.
This retrospective study collected the data from patients diagnosed as Gross type C CEA and underwent surgical repair at our institution between January 2013 and December 2022. Comprehensive data, including demographic characteristics, preoperative comorbidities, perioperative indicators, and postoperative outcomes were collected and analyzed. We performed univariate analysis followed by multivariate binary logistic regression analysis to clarify the effect of IV on ES.
Among the 250 infants included in this study, 35 cases (14.0%) developed ES. Operative duration was significantly longer in ES cases (median: 127 vs 106 min, P = 0.007). Postoperative invasive ventilation (82.9% vs 61.4%, P = 0.014), reintubation (40.0% vs 11.2%; P = 0.001), anastomotic leakage (34.3% vs 17.7%, P = 0.023), and prolonged hospitalization (median: 35 vs 24 days, P = 0.003) were more frequent in ES infants. Multivariable analysis confirmed postoperative reintubation (adjusted OR = 3.497, P = 0.007) as independent risk factors for ES.
Postoperative reintubation was an independent risk factor for ES following type C CEA repair. To reduce the need for reintubation, individualized respiratory support strategies were recommended.
探讨术前有创通气（IV）、术后IV及再次插管对C型颈动脉内膜切除术（CEA）患者发生食管狭窄（ES）的影响。
本回顾性研究收集了2013年1月至2022年12月期间在我院被诊断为大体C型CEA并接受手术修复的患者的数据。收集并分析了包括人口统计学特征、术前合并症、围手术期指标和术后结局在内的综合数据。我们先进行单因素分析，然后进行多因素二元逻辑回归分析，以阐明IV对ES的影响。
本研究纳入的250例婴儿中，35例（14.0%）发生了ES。ES病例的手术时间明显更长（中位数：127分钟对106分钟，P = 0.007）。ES婴儿术后有创通气（82.9%对61.4%，P = 0.014）、再次插管（40.0%对11.2%；P = 0.001）、吻合口漏（34.3%对17.7%，P = 0.023）及住院时间延长（中位数：35天对24天，P = 0.003）的情况更常见。多变量分析证实术后再次插管（校正比值比=3.497，P = 0.007）是ES的独立危险因素。
术后再次插管是C型CEA修复术后发生ES的独立危险因素。为减少再次插管的需求，建议采用个体化的呼吸支持策略。
