Comparative Outcomes of Flap Maturation Versus Conventional Pediatric Tracheotomy Techniques.

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Laryngoscope Pub Date : 2025-09-08 DOI:10.1002/lary.70090

Alexandra F Corbin, Nick Sahlollbey, Gaayathri Varavenkataraman, Hardeep S Tiwana, Kaitlyn A VanBockern, Erin M Gawel, Ellen Piccillo, Michele M Carr

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引用次数: 0

Abstract

Objective: To compare postoperative outcomes of flap maturation (FMT) and conventional tracheotomy techniques in pediatric patients.

Methods: A retrospective cohort study was performed using data from the American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2020-2021). Pediatric patients ≤ 18 years who underwent FMT (CPT 31610) or conventional tracheotomy (CPT 31600, 31,601) were included. Primary outcomes were 30-day reoperation, surgical site infection, pneumonia, seizures, mortality, unplanned reintubation, readmission, and length of stay.

Results: Among 2353 patients (mean age 2.9 years, 95% CI 2.7-3.1), 381 (16.2%) underwent FMT and 1972 (83.8%) underwent conventional tracheotomy. An FMT was associated with lower odds of 30-day reoperation (0.5% vs. 3.3%, p = 0.003; adjusted OR = 0.17, 95% CI 0.1-0.6, p = 0.005). Rates of surgical site infection, pneumonia, and seizures did not differ significantly between groups after adjustment. No differences were observed in mortality, reintubation, readmission, or length of stay.

Conclusion: FMT is independently associated with lower reoperation rates without increased postoperative complications. FMT may be a favorable tracheotomy option for select patients and warrants consideration during surgical decision-making to optimize outcomes.

Level of evidence: 3:

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皮瓣成熟与常规儿科气管切开术的比较结果。

目的：比较皮瓣成熟（FMT）与常规气管切开术在儿科患者的术后疗效。方法：采用美国外科医师学会国家手术质量改进计划儿科数据库（2020-2021）的数据进行回顾性队列研究。接受FMT （CPT 31610）或常规气管切开术（CPT 31600, 31601）的≤18岁的儿童患者被纳入研究。主要结局为30天再手术、手术部位感染、肺炎、癫痫发作、死亡率、计划外再插管、再入院和住院时间。结果：2353例患者（平均年龄2.9岁，95% CI 2.7-3.1）中，381例（16.2%）行FMT， 1972例（83.8%）行常规气管切开术。FMT与较低的30天再手术几率相关（0.5% vs. 3.3%, p = 0.003；调整OR = 0.17, 95% CI 0.1-0.6, p = 0.005）。调整后，两组手术部位感染、肺炎和癫痫发作的发生率无显著差异。在死亡率、再插管、再入院或住院时间方面没有观察到差异。结论：FMT与较低的再手术率独立相关，且不增加术后并发症。对于某些患者，FMT可能是一种有利的气管切开术选择，值得在手术决策时考虑以优化结果。证据等级：3；

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects