Cricotracheal resection for adult subglottic stenosis: Factors predicting treatment failure

Autor: Carsten E. Palme, Shaf Keshavjee, Ralph W. Gilbert, Patrick J. Gullane, Andrew Pierre, Antti Mäkitie, David P. Goldstein, Ashok R. Jethwa, Wael Hasan, Osvaldo Espin-Garcia
Přispěvatelé: HUS Head and Neck Center, Department of Ophthalmology and Otorhinolaryngology, Korva-, nenä- ja kurkkutautien klinikka, Helsinki University Hospital Area, Clinicum
Rok vydání: 2019
Předmět:
Adult
Male
Reoperation
medicine.medical_specialty
Glottis
Time Factors
Subglottic stenosis
Thyroid Gland
Laryngectomy
Anastomosis
LARYNX
Treatment failure
Catheterization
Cricoid Cartilage
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Tracheostomy
Restenosis
Recurrence
Medicine
Humans
PARTIAL CRICOID RESECTION
Adult subglottic stenosis
3125 Otorhinolaryngology
ophthalmology
Treatment Failure
10. No inequality
030223 otorhinolaryngology
Retrospective Studies
cricotracheal resection
Cricotracheal resection
business.industry
Anastomosis
Surgical
prognostic factors
Retrospective cohort study
Laryngostenosis
Odds ratio
Middle Aged
medicine.disease
3. Good health
Surgery
Trachea
Stenosis
Otorhinolaryngology
030220 oncology & carcinogenesis
LARYNGOTRACHEAL RECONSTRUCTION
Female
business
Tracheal Stenosis
Zdroj: The LaryngoscopeBIBLIOGRAPHY. 130(7)
ISSN: 1531-4995
Popis: OBJECTIVES/HYPOTHESIS Identify predictors of decannulation failure after cricotracheal resection (CTR) and thyrotracheal anastomosis (TTA) in patients with subglottic stenosis (SGS). STUDY DESIGN Retrospective cohort study. METHODS Charts of patients undergoing CTR and TTA for SGS at the University Health Network, Toronto, Ontario, Canada between 1988 and 2017 were reviewed. Patient, pathology, treatment, and outcome data were collected. The end points for statistical analysis were development of restenosis and permanent tracheostomy. RESULTS One hundred fourteen patients (n = 114) were eligible for inclusion in this review. The mean age at primary resection was 46.9 years, 95 (83%) were females, and 19 (17%) were males. The rate of restenosis and permanent tracheostomy was 13% and 5%, respectively. Sixty-two patients (54%) underwent a CTR and TTA, and 52 patients (46%) underwent a CTR, laryngofissure, and TTA. Traumatic stenosis (odds ratio [OR] = 10.3, P = .017), longer T-tube duration (OR = 1.2, P = .011), combined glottic/subglottic stenosis (OR = 10.47, P = .010), start of the stenosis at the vocal cords (OR = 6.6, P = .029), postoperative minor complications (OR = 13.6, P = .028), and need for repeat surgery (OR = 44.1, P
Databáze: OpenAIRE
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