Cervical Tracheal Resection: New Lessons Learned
| Autor: | Shady M. Eldaif, Christopher J. Mutrie, William Grist, Daniel L. Miller, Kamal A. Mansour, Caleb Rutledge, Seth D. Force |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Anastomosis Young Adult medicine Humans Myocardial infarction Young adult Aged Retrospective Studies business.industry Retrospective cohort study Middle Aged medicine.disease Chin Surgery Tracheal Stenosis Stenosis medicine.anatomical_structure Etiology Female Tracheotomy Cardiology and Cardiovascular Medicine business Neck |
| Zdroj: | The Annals of Thoracic Surgery. 91:1101-1106 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2010.11.066 |
| Popis: | Background Cervical tracheal stenosis can be a difficult condition to manage. Depending on the etiology, location, and extent of the stenosis, tracheal or cricotracheal resection may be required. Intraoperative decisions may predict outcome. Methods We performed a retrospective chart review of all patients undergoing cervical tracheal or cricotracheal resection from April 2000 through March 2008. Results One hundred and five patients underwent 108 tracheal or cricotracheal resections. Median age was 65 years (range, 15 to 78); 68% were women. Indication for operation included postintubation tracheal stenosis (38), idiopathic (31), tracheostomy stenosis (19), invasive thyroid cancer (9), and other (8). Median length of trachea resected was 2.7 cm (range, 1.5 to 6.0 cm); 48 patients (46%) underwent extended cricotracheal resections. Twenty-six patients (25%) had an intraoperative chin stitch placed. Hospital stay was a median of 4 days (range, 2 to 33). Operative mortality was (1%); 1 patient died of myocardial infarction on postoperative day 3. Four patients (4%) had hoarseness or vocal cord immobility. Median follow-up was 36 months (range, 1 to 79). Eighteen patients (17%) required dilation postoperatively. Seven patients (7%) required tracheostomy; 2 (2%) are tracheostomy dependent. Three patients (3%) underwent a re-resection for recurrent stenosis. Multivariate analysis of indication for resection, type of resection, length of resection, anastomotic technique, and use of chin stitch did not predict the need for postoperative dilation, tracheostomy, or reoperation. Conclusions Cervical tracheal resection can be performed safely with low morbidity and mortality. Only 5% of patients required a long-term tracheostomy or re-resection for recurrent tracheal stenosis. Specific intraoperative decisions did not predict long-term success. |
| Databáze: | OpenAIRE |
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