Duration of stenting in single-stage laryngotracheal reconstruction with anterior costal cartilage grafts.
In single-stage laryngotracheal reconstruction (ss-LTR), the endotracheal tube is used as a stent. The optimal duration of stenting is not known. The stenting period requires a stay in the intensive care unit, as the patient is intubated. Sedation and, rarely, paralysis may be required. An analysis from a prospectively collected database was performed to investigate the effect of length of stenting on the outcome of ss-LTR. The outcomes used were reintubation rate and postoperative tracheostomy rate. Patients with anterior costal graft ss-LTR were selected, as they had undergone similar procedures and have similar stenosis types and grades. In 101 patients, the duration of stenting ranged from 2 to 14 days (mean, 7 days; SD, 2.6 days). No significant correlation was found between the number of days stented and the reintubation rate or the postoperative tracheostomy rate. Patients stented for longer than I week were an average of 15 months younger than those stented for less than 1 week; however, the stenosis grades for the two populations were equivalent. The differences in rates of reintubation (p = .68) and postoperative tracheostomy (p = .52) in these 2 groups were not significant. For patients undergoing ss-LTR with anterior costal cartilage grafts, no correlation was found between the number of days stented (intubated) and the reintubation rate or the postoperative tracheostomy rate.
Hartley
B E
BE
Department of Pediatric Otolaryngology, The Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Gustafson
L M
LM
Liu
J H
JH
Hartnick
C J
CJ
Cotton
R T
RT
D000293:Adolescent; D002356:Cartilage / Q000637:transplantation*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014135:Tracheal Stenosis / Q000601:surgery*; D014139:Tracheostomy; D016896:Treatment Outcome