A nationwide survey on the safety of cricothyrotomy: a multicenter retrospective study in Japan.

Autor: Booka E; Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-Ku, Hamamatsu, Shizuoka, 431-3192, Japan., Takeuchi H; Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-Ku, Hamamatsu, Shizuoka, 431-3192, Japan. takeuchi@hama-med.ac.jp., Kikuchi H; Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-Ku, Hamamatsu, Shizuoka, 431-3192, Japan., Miura A; Department of Esophageal Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan., Kanda M; Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Kawaguchi Y; First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan., Hamai Y; Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan., Nasu M; Department of Esophageal and Gastroenterological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan., Sato S; Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan., Inoue M; Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan., Okubo K; Department of Otolaryngology, Sano Kosei General Hospital, Tochigi, Japan., Ogawa R; Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan., Sato H; Department of Gastroenterological Surgery, Saitama International Medical Center, Saitama Medical University, Saitama, Japan., Yoshino S; Departments of Surgery, NHO Kanmon Medical Center, Shimonoseki, Japan., Takebayashi K; Department of Surgery, Shiga University of Medical Science, Shiga, Japan., Kono K; Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan., Toh Y; Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan., Katori Y; Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Jazyk: angličtina
Zdroj: Esophagus : official journal of the Japan Esophageal Society [Esophagus] 2024 Sep 06. Date of Electronic Publication: 2024 Sep 06.
DOI: 10.1007/s10388-024-01082-8
Abstrakt: Background: Cricothyrotomy is a widely performed potentially life-saving treatment to secure an airway in emergencies. It is also a pneumonia-preventing treatment to secure an expectorant route in patients with difficulty self-expelling sputum; however, its safety and usefulness remain unclear. Thus, we conducted a nationwide survey of cricothyrotomy.
Methods: We retrospectively collected and analyzed cricothyrotomy data from the institutions certified by the Japan Broncho-Esophagological Society or the Japanese Esophageal Society. Ultimately, 116 facilities responded to the survey and the present study included 1001 patients from 26 facilities who underwent cricothyrotomies from January 1, 2010 to December 31, 2021.
Results: Cricothyrotomy was performed for sputum suctioning after esophagectomy or other surgical procedures in 945 (94.4%) cases and for emergency airway clearance in 48 (4.8%) cases. Complications during puncture were observed in 12 (1.2%) cases. We found significantly fewer complications during puncture for sputum suction (1.0%) compared with emergency airway clearance (4.2%) (p = 0.002), and also at the condition after esophagectomy (0.5%) compared with other surgical procedures (7.8%) (p < 0.001). Complications after puncture were observed in 45 (4.5%) cases, and we found significantly fewer complications after puncture at the condition after esophagectomy (4.2%) compared with other surgical procedures (11.8%) (p = 0.032). There were no significant differences in the type of kit used for complications during and after the puncture.
Conclusions: Cricothyrotomy for prophylactic sputum suctioning after esophagectomy was safer compared to emergency airway clearance. However, future studies should verify the efficacy of cricothyrotomy.
(© 2024. The Author(s) under exclusive licence to The Japan Esophageal Society.)
Databáze: MEDLINE
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