title: Securing stent during multi-stage laryngotracheoplasty--an evolved technique.
abstract: BACKGROUND
  Multi-stage laryngotracheoplasty (LTP) typically requires a stent be secured to the airway for 2-6 weeks. Our technique has evolved over time to securing the stent to the strap muscles and tying a series of knots long enough to leave the suture tail protruding through the skin incision, which simplifies stent removal.
  
  
  METHODS
  Retrospective chart review.
  
  
  RESULTS
  Twenty-four patients underwent multi-stage LTP at our institution from 2007 to 2013. Eight patients were excluded from the study because they either did not have a stent placed (n=4), or they had a t-tube placed which was not sutured in place (n=4). Of the remaining 16 patients, 62.5% (n=10) had their stent secured via sutures which were buried below the skin, and 37.5% (n=6) via a long suture tail which was left protruding through the end of the skin incision. An incision was required for stent removal 100% of buried sutures patients, and 33% of exposed suture patients (p=0.0009). Average operative time for stent removal was 60min in the buried sutures group, and 25min in the exposed sutures group (p=0.0075).
  
  
  CONCLUSIONS
  Securing stents via an exposed suture technique decreases the need for making a skin incision during the second stage of the operation, and significantly decreases the operative time of the second stage.
authors.affiliation: Children's Hospital of Michigan, Detroit, MI, United States; Wayne State University School of Medicine, Detroit, MI, United States. Electronic address: siegel.bianca@gmail.com.
authors.forename: Bianca
authors.initials: B
authors.lastname: Siegel
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY, United States; Montefiore Medical Center, Bronx, NY, United States; Children's Hospital at Montefiore, Bronx, NY, United States.
authors.forename: John P
authors.initials: JP
authors.lastname: Bent
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D058753:Laryngoplasty / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D013536:Suture Techniques; D013537:Sutures; D014132:Trachea / Q000601:surgery*
keywords: Airway stent; Laryngotracheal reconstruction; Laryngotracheoplasty; Multi-stage LTP