Single-stage laryngotracheal reconstruction: the Great Ormond Street experience and guidelines for patient selection
| Autor: | S.E.J Leighton, David M. Albert, Xu G. Guo, Nina L. Shapiro, Chapman T. McQueen |
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| Rok vydání: | 1999 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Gestational Age Tracheotomy medicine Intubation Intratracheal Intubation Humans Child Retrospective Studies business.industry Incidence (epidemiology) Patient Selection Body Weight Gestational age Infant Retrospective cohort study Laryngostenosis General Medicine Surgery Trachea Plastic surgery Treatment Outcome Otorhinolaryngology Relative risk Child Preschool Female medicine.symptom Larynx business Subcutaneous emphysema |
| Zdroj: | Archives of otolaryngology--headneck surgery. 125(3) |
| ISSN: | 0886-4470 |
| Popis: | Objectives To review all patients undergoing single-stage laryngotracheal reconstruction and to determine guidelines to predict successful outcomes and prevent the necessity of tracheotomy following laryngotracheal reconstruction. Design Chart review. Setting Tertiary care children's hospital. Patients A retrospective chart review was performed at our institution involving all patients who underwent single-stage laryngotracheal reconstruction from 1993 through 1996. A total of 28 patients were reviewed. Results Based on this chart review, a statistically higher incidence of extubation complications ( P =.045), ie, bleeding, reintubation, or subcutaneous emphysema, occurred in children who weighed less than 4 kg. Although not statistically significant ( P >.99), the relative risks of failure, defined as tracheotomy dependent or significant airway compromise following single-stage laryngotracheal reconstruction, were 3.43 if the child's weight was less than 4 kg at the time of surgery and 2.31 if the gestational age was less than 30 weeks at the time of surgery. Length of time for intubation did not appear to have any effect on outcome. Conclusions Patients' gestational age and weight at the time of surgery appear to have the most impact on successful outcome. Children weighing more than 4 kg and those with gestational age of greater than 30 weeks appear to have a greater chance at successful extubation and eventual patent airway. Duration of intubation following single-stage laryngotracheal reconstruction does not appear to affect outcome. |
| Databáze: | OpenAIRE |
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