Analysis of Complications in (Crico-) Tracheal Resection Anastomosis in Adults: A Multicenter Study.
Adult
Aged
Female
Humans
Middle Aged
Anastomosis, Surgical
/ adverse effects
Constriction, Pathologic
/ etiology
Cricoid Cartilage
/ surgery
Laryngostenosis
/ surgery
Postoperative Complications
/ epidemiology
Retrospective Studies
Trachea
/ surgery
Tracheal Stenosis
/ surgery
Treatment Outcome
Male
complications
cricotracheal resection
laryngeal stenosis
risk factors
surgery
tracheal resection
tracheal stenosis
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
09
02
2023
received:
06
08
2022
accepted:
09
02
2023
medline:
23
10
2023
pubmed:
9
3
2023
entrez:
8
3
2023
Statut:
ppublish
Résumé
The gold standard treatments for advanced laryngotracheal stenosis (LTS) are represented by partial crico-tracheal (PCTRA) or tracheal resection and anastomosis (TRA). These procedures are potentially burdened by high postoperative complication rates. We investigated the impact of the most common stenosis and patient-related characteristics on the onset of complications in a multicentric cohort. We retrospectively analyzed patients who underwent PCTRA or TRA for LTS of different etiologies in three referral centers. We tested the effectiveness of these procedures, the impact of complications on the outcomes, and identified factors causing postoperative complications. A total of 267 patients were included in the study (130 females; mean age, 51.46 ± 17.64 years). The overall decannulation rate was 96.4%. Altogether, 102 (38.2%) patients presented at least one complication, whereas 12 (4.5%) had two or more. The only independent predictor of post-surgical complications was the presence of systemic comorbidities (p = 0.043). Patients experiencing complications needed additional surgery more frequently (70.1% vs. 29.9%, p < 0.001), and had a longer duration of hospitalization (20 ± 10.9 vs. 11.3 ± 4.1 days, p < 0.001). Six of 102 (5.9%) patients with complications had restenosis, although this event did not occur among patients without complications. PCTRA and TRA have an excellent success rate even when performed for high-grade LTS. However, a significant percentage of patients may experience complications associated with a longer duration of hospitalization or the need for additional surgeries. The presence of medical comorbidities was independently related to an increased risk of complications. 4 Laryngoscope, 133:2910-2919, 2023.
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2910-2919Informations de copyright
© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
Références
Smith MM, Cotton RT. Diagnosis and management of laryngotracheal stenosis. Expert Rev Respir Med. 2018;12(8):709-717.
Giudice M, Piazza C, Foccoli P, Toninelli C, Cavaliere S, Peretti G. Idiopathic subglottic stenosis: management by endoscopic and open-neck surgery in a series of 30 patients. Eur Arch Otorhinolaryngol. 2003;260(5):235-238.
Damrose EJ. On the development of idiopathic subglottic stenosis. Med Hypotheses. 2008;71(1):122-125.
Timman ST, Schoemaker C, Li WWL, et al. Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis. Ann Cardiothorac Surg. 2018;7(2):227-236.
Hseu AF, Benninger MS, Haffey TM, Lorenz R. Subglottic stenosis: a ten-year review of treatment outcomes. Laryngoscope. 2014;124(3):736-741.
D'Andrilli A, Maurizi G, Andreetti C, et al. Long-term results of laryngotracheal resection for benign stenosis from a series of 109 consecutive patients. Eur J Cardiothorac Surg. 2016;50(1):105-109.
Rotolo N, Cattoni M, Imperatori A. Complications from tracheal resection for thyroid carcinoma. Gland Surg. 2017;6(5):574-578.
Wright CD, Grillo HC, Wain JC, et al. Anastomotic complications after tracheal resection: prognostic factors and management. J Thorac Cardiovasc Surg. 2004;128(5):731-739.
Nakao K, Kurozumi K, Nakahara M, Kido T. Resection and reconstruction of the airway in patients with advanced thyroid cancer. World J Surg. 2004;28(12):1204-1206.
Monnier P, Dikkers FG, Eckel H, et al. Preoperative assessment and classification of benign laryngotracheal stenosis: a consensus paper of the European laryngological society. Eur Arch Otorhinolaryngol. 2015;272(10):2885-2896.
Filauro M, Mazzola F, Missale F, Canevari FR, Peretti G. Endoscopic preoperative assessment, classification of stenosis, decision-making. Front Pediatr. 2020;7(January):1-13.
Myer CM 3rd, O'Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol. 1994;103(4 Pt 1):319-323.
Fiz I, Monnier P, Koelmel JC, et al. Multicentric study applying the european laryngological society classification of benign laryngotracheal stenosis in adults treated by tracheal or cricotracheal resection and anastomosis. Laryngoscope. 2020;130(7):1640-1645.
Piazza C, del Bon F, Paderno A, et al. Complications after tracheal and cricotracheal resection and anastomosis for inflammatory and neoplastic stenoses. Ann Otol Rhinol Laryngol. 2014;123(11):798-804.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383.
Gelbard A, Francis DO, Sandulache VC, Simmons JC, Donovan DT, Ongkasuwan J. Causes and consequences of adult laryngotracheal stenosis. Laryngoscope. 2015;125(5):1137-1143.
Cesare P, Lancini D, Filauro M, et al. Post-COVID-19 airway stenosis treated by tracheal resection and anastomosis: a bicentric experience. Acta Otorhinolaryngol Ital. 2022;42(2):99-105.
Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011;55(2):111-115.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-213.
Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992;111(5):518-526.
Piazza C, Lancini D, Tomasoni M, et al. Tracheal and Cricotracheal resection with end-to-end anastomosis for locally advanced thyroid cancer: a systematic review of the literature on 656 patients. Front Endocrinol (Lausanne). 2021;12:12.
Gaissert HA, Grillo HC, Shadmehr MB, et al. Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina. Ann Thorac Surg. 2004;78(6):1887-1889.
Gaissert HA, Grillo HC, Shadmehr BM, et al. Laryngotracheoplastic resection for primary tumors of the proximal airway. J Thorac Cardiovasc Surg. 2005;129(5):1006-1009.
Rüller K, Sittel C, Kölmel JC, et al. Organ preservation strategies in laryngeal chondrosarcoma. Laryngoscope. 2022;132(4):838-843.
Tawfik KO, Houlton JJ, Compton W, Ying J, Khosla SM. Laryngotracheal reconstruction: a ten-year review of risk factors for decannulation failure. Laryngoscope. 2015;125(3):674-679.
Fehervari M, Patel S, Towning R, et al. Management of Laryngotracheal Stenosis in obesity. Is this another Co-morbidity that can Be improved with weight loss following bariatric surgery? Obes Surg. 2021;31(11):4815-4820.
Cui PC, Zhao DQ, Guo ZH, Liang LP, Wang W. Effect of partial cricotracheal resection and extended cricotracheal resection for severe laryngotracheal stenosis. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020;55(2):94-97.
Fiz I, Monnier P, Koelmel JC, et al. Implementation of the European laryngological society classification for pediatric benign laryngotracheal stenosis: a multicentric study. Eur Arch Otorhinolaryngol. 2019;276(3):785-792.
Fiz I, Bittar Z, Piazza C, et al. Hormone receptors analysis in idiopathic progressive subglottic stenosis. Laryngoscope. 2018;128(2):E72-E77.
Catano J, Uzunhan Y, Paule R, et al. Presentation, diagnosis, and Management of Subglottic and Tracheal Stenosis during Systemic Inflammatory Diseases. Chest. 2022;161(1):257-265.
Costantino CL, Niles JL, Wright CD, Mathisen DJ, Muniappan A. Subglottic stenosis in granulomatosis with polyangiitis: the role of laryngotracheal resection. Ann Thorac Surg. 2018;105(1):249-253.
Herridge MS, Pearson FG, Downey GP. Subglottic stenosis complicating Wegener's granulomatosis: surgical repair as a viable treatment option. J Thorac Cardiovasc Surg. 1996;111(5):961-966.