Laryngotracheal separation surgery: outcome in 60 patients.
OBJECTIVE
To determine the outcome of laryngotracheal separation (LTS) in 60 patients in terms of the control and prevention of severe and persistent aspiration, morbidity and mortality, reversibility rate, and the influence of the presence of a tracheostomy.


METHODS
Retrospective study.


RESULTS
LTS showed significant efficacy rates in terms of both treatment (87%) and prevention (100%) of pulmonary aspiration. Twenty-six (43%) patients developed postoperative complications. A tracheocutaneous fistula of the proximal tracheal stump was observed in 14 (23%) patients and was the most frequent complication, especially in patients with a therapeutic indication (P = 0.028) and in those with a tracheostomy (P = 0.058). Reversion of LTS was possible in 12 (20%) patients, mainly those with a prophylactic indication (P = 0.005). However, the rates of complications (58%) and inefficacy (27%) of reversion surgery were high.


CONCLUSIONS
LTS is effective in the elimination and prevention of clinically intractable aspiration. The procedure is potentially reversible. However, the frequency of complications for both LTS and reversion surgery is significant.
Zocratto
Orlando B
OB
Alpha Institute of Gastroenterology, University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil. orbazocratto@ig.com.br
Savassi-Rocha
Paulo R
PR
Paixão
Rafael M
RM
Salles
José M P
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000601:surgery*; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D014139:Tracheostomy; D016896:Treatment Outcome