Higashidate Naruki, Hashizume Naoki, Koga Yoshinori, Masui Daisuke, Sakamoto Saki, Kurahachi Tomohiro, Yoshida Hiroki, Kaji Tatsuru
Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Pediatr Surg Int. 2025 Aug 18;41(1):250. doi: 10.1007/s00383-025-06150-3.
This study aimed to analyze laryngotracheal separation (LTS) outcomes and evaluate the efficacy of the evaluation criteria for prophylactic innominate artery transection (PIAT) in neurologically impaired patients.
67 patients who underwent LTS were reviewed. They were divided into three groups: patients without a tracheostomy tube (TT) (Group 1), patients with a TT but without PIAT (Group 2) and patients with TT and PIAT (Group 3). The length between the dorsal edge of the sternum and ventral edge of the vertebra (D-to-V), tracheal flattening ratio (TFR), and mediastinum-thoracic anteroposterior ratio (MTR), as evaluation criteria for PIAT based on the previous studies were measured.
62 patients [F/M = 25/37, Group 1 (n = 27), Group 2 (n = 29), and Group 3 (n = 6)] were analyzed. Three patients in Group 3 underwent PIAT after LTS due to intratracheal granuloma and minor bleeding. The TFR in Group 3 was significantly lower than that in Group 1 and 2 (p = 0.0236, 0.0054). The proportions of patients who met the criteria for PIAT were 5cases (8.06%) assessed by D-to-V, 21cases (33.87%) by TFR, and 37cases (59.68%) by MTR.
D-to-V would be the efficient criteria for PIAT and low TFR and MTR patients should be followed up carefully.
本研究旨在分析喉气管分离术（LTS）的结果，并评估预防性无名动脉横断术（PIAT）评估标准在神经功能受损患者中的有效性。
回顾了67例行LTS的患者。他们被分为三组：无气管造口管（TT）的患者（第1组）、有TT但未行PIAT的患者（第2组）和有TT且行PIAT的患者（第3组）。根据先前研究测量胸骨后缘与椎体腹缘之间的长度（D至V）、气管扁平率（TFR）和纵隔-胸廓前后径比（MTR），作为PIAT的评估标准。
分析了62例患者[女/男 = 25/37，第1组（n = 27），第2组（n = 29），第3组（n = 6）]。第3组中有3例患者在LTS后因气管内肉芽肿和少量出血而行PIAT。第3组的TFR显著低于第1组和第2组（p = 0.0236，0.0054）。符合PIAT标准的患者比例按D至V评估为5例（8.06%），按TFR评估为21例（33.87%），按MTR评估为37例（59.68%）。
D至V将是PIAT的有效标准，TFR和MTR较低的患者应仔细随访。
