التفاصيل البيبلوغرافية
| العنوان: |
Decannulation in Revision Pediatric Laryngotracheal Reconstruction. |
| المؤلفون: |
Leonard, James A., Blumenthal, Daniel L., Behzadpour, Hengameh K., Lawlor, Claire M., Preciado, Diego |
| المصدر: |
Laryngoscope; Apr2024, Vol. 134 Issue 4, p1926-1932, 7p |
| مستخلص: |
Objectives: To evaluate how patient characteristics and surgical techniques influence the rate of and time to decannulation after pediatric revision laryngotracheal reconstruction. Methods: The study was a retrospective cohort investigation of children with a history of laryngotracheal stenosis treated between 2008 and 2021 with revision open airway surgery. The primary outcome evaluated was decannulation. The secondary outcome analyzed was time to decannulation. Results: Thirty‐nine children were included in the study with median age 49 months; 61.5% were male. Children undergoing single stage revision surgery were far more likely to be decannulated (OR 6.25, 95% CI 1.33–45.97, p = 0.0343). Rolling logistic regression of the probability of decannulation stratified by time between open surgeries demonstrated significantly decreased chance of decannulation with reoperation within 6 months. Children managed with anterior/posterior grafting compared with a single graft were observed to have an increased time to decannulation, (HR 0.365, 95% CI 0.148–0.899, p = 0.005, Log‐Rank). Conclusion: We observe that in the case of revision pediatric open airway surgery, chance of decannulation is improved when surgery is performed in a single stage as well as 6 months after the most recent procedure. Patients and families should be counseled that complex stenosis requiring double stage procedures or anterior/posterior grafting is associated with a decreased probability of decannulation and increased postoperative time with a tracheostomy, respectively. Level of Evidence: 4 Laryngoscope, 134:1926–1932, 2024 [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |