Abstract：
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.
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.
摘要：
目的：晚期喉气管狭窄（LTS）的金标准治疗以部分环气管（PCTRA）或气管切除吻合（TRA）为代表。这些手术可能会受到高术后并发症发生率的困扰。我们调查了多中心队列中最常见的狭窄和患者相关特征对并发症发作的影响。
方法：我们回顾性分析了在三个转诊中心接受PCTRA或TRA治疗不同病因的LTS的患者。我们测试了这些程序的有效性，并发症对结局的影响，并确定了导致术后并发症的因素。
结果：本研究共纳入267例患者（130例女性；平均年龄，51.46±17.64年）。总体拔管率为96.4%。总之,102例（38.2%）患者出现至少一种并发症，而12例(4.5%)有2例或2例以上。术后并发症的唯一独立预测因素是全身合并症的存在（p=0.043）。出现并发症的患者需要更频繁地进行额外的手术（70.1%vs.29.9%,p<0.001)，并且住院时间更长(20±10.9vs.11.3±4.1天，p<0.001)。102例并发症患者中有6例（5.9％）出现再狭窄，尽管该事件未发生在无并发症的患者中.
结论：PCTRA和TRA即使在高级别LTS中也具有出色的成功率。然而,相当比例的患者可能会出现与住院时间较长或需要额外手术相关的并发症.医疗合并症的存在与并发症风险的增加独立相关。
方法：4喉镜，2023年。
方法：我们回顾性分析了在三个转诊中心接受PCTRA或TRA治疗不同病因的LTS的患者。我们测试了这些程序的有效性，并发症对结局的影响，并确定了导致术后并发症的因素。
结果：本研究共纳入267例患者（130例女性；平均年龄，51.46±17.64年）。总体拔管率为96.4%。总之,102例（38.2%）患者出现至少一种并发症，而12例(4.5%)有2例或2例以上。术后并发症的唯一独立预测因素是全身合并症的存在（p=0.043）。出现并发症的患者需要更频繁地进行额外的手术（70.1%vs.29.9%,p<0.001)，并且住院时间更长(20±10.9vs.11.3±4.1天，p<0.001)。102例并发症患者中有6例（5.9％）出现再狭窄，尽管该事件未发生在无并发症的患者中.
结论：PCTRA和TRA即使在高级别LTS中也具有出色的成功率。然而,相当比例的患者可能会出现与住院时间较长或需要额外手术相关的并发症.医疗合并症的存在与并发症风险的增加独立相关。
方法：4喉镜，2023年。
