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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Cricotracheal resection for adult subglottic stenosis: Factors predicting treatment failure
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Cricotracheal resection for adult subglottic stenosis: Factors predicting treatment failure

机译：成人缩小狭窄的危害切除术：预测治疗失败的因素

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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 ?.001) were associated with an increased risk of requiring permanent tracheostomy. Conclusions CTR and TTA are excellent surgical approaches for adult patients with subglottic stenosis. In this study, 5% of patients required permanent tracheostomy. Factors predicting treatment failure include traumatic stenosis, longer T‐tube duration, combined glottic/subglottic stenosis, start of stenosis at the level of vocal cords, postoperative minor complications, and need for repeat surgery. Level of Evidence 4 Laryngoscope , 130:1634–1639, 2020
机译：目的/假设鉴定序列狭窄（SGS）患者患有CricoTracheal切除（CTR）和蜂鸣器吻合术（TTA）后的分裂衰竭的预测因子。研究设计回顾性队列研究。方法综述了1988年至2017年间加拿大大学健康网络，多伦多，在大学健康网络中进行CTR和TTA患者的患者表。收集患者，病理，治疗和结果数据。统计分析的终点是转胸和永久气管造口术的发展。结果一百十四名患者（n = 114）有资格包涵在本综述中。初级切除术的平均年龄为46.9岁？岁月，95（83％）是女性，19例（17％）是男性。再狭窄和永久气管造口术的速率分别为13％和5％。六十二名患者（54％）接受了CTR和TTA，52名患者（46％）接受了CTR，喉发裂和TTA。创伤性狭窄（差距[或] = 10.3，p = 017），较长的T型管持续时间（或= 1.2，p =Δ.011），组合的喇叭/子凝集狭窄（或= 10.47，p = 010 ），在声带（或= 6.6，P =β.029）的狭窄开始，术后次要并发症（或= 13.6，p = 028），并且需要重复手术（或= 44.1，p＆ ？.001）与需要永久气管造影术的风险增加。结论Ctr和TTA是成年患者患者囊狭窄的优异手术方法。在这项研究中，5％的患者需要永久性气管造口术。预测治疗失败的因素包括创伤性狭窄，较长的T型管持续时间，组合的钟声/缩小狭窄，在声带水平，术后次要并发症水平上开始狭窄，需要重复手术。证据水平4喉镜，130：1634-1639,2020

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