Primary vs. secondary closure of tracheocutaneous fistulas: A prospective cohort study

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-02-26 DOI:10.1016/j.ijporl.2025.112293

Alisa Timashpolsky , Luv Javia , Ian Jacobs , Conor Devine , Terri Giordano , Karen B. Zur , Ryan Borek , Steven Sobol

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引用次数: 0

Abstract

Objective

To prospectively compare outcomes and complications of the two most common techniques for closure of tracheocutaneous fistulas (TCFs): surgical excision of the tract with primary closure (PC), and de-epithelialization with healing by secondary intention (SI).

Study design

Prospective cohort study.

Setting

Tertiary academic center.

Methods

All patients who underwent closure of a TCF between 5/1/2022 and 5/30/2023 were eligible for inclusion in the study. Data was prospectively collected and included demographics, tracheostomy history, intraoperative data (including fistula size and closure technique), postoperative recovery and any complications.

Results

There were 15 patients who underwent PC, and 10 patients who underwent closure by SI. Both cohorts were premature and had tracheostomies for at least 2 years prior to decannulation. The length of time from decannulation to closure was longer in the primary vs secondary group (p = .01). The operative time was significantly longer in the PC group (p = .002) and the PC group experienced a significantly higher number of postoperative respiratory complications (p = .05) during their postoperative admission. The average TCF size was larger in the SI group compared to the PC group (p < 0.001).

Conclusion

This prospective study demonstrated fewer postoperative respiratory complications for SI closure of TCFs compared to PC.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.