Abstract
Purpose
The factors related to infectious complications after tracheoplasty for congenital tracheal stenosis (CTS) remain unclear; we, therefore, assessed these factors in this study.
Methods
We divided 47 patients who underwent slide tracheostomy and tracheal resection for CTS between May 2016 and December 2020 into an infected group and a non-infected group. Their characteristics were compared between groups. Results are presented as the median (range) or incidence.
Results
Infectious complications were observed in 12 patients (25.5%). Empyema and mediastinitis were seen in 5 cases (10.6%). There was a significant difference in the following factors in the infected and non-infected groups, respectively: weight, 5457 (2868–20,750) g and 6554 (2275–20,800) g (p = 0.025); surgical time, 575.5 (313–646) min and 349 (270–651) min (p < 0.001); extracorporeal circulation time, 303.5 (186–610) min and 216 (117–478) min (p = 0.001); and postoperative intubation time, 13 (7–28) days, and 6 (5–22) days (p < 0.001). Age, malnutrition, cardiovascular comorbidities, and preoperative methicillin-resistant Staphylococcus aureus detection were not significantly different between the two groups.
Conclusion
There were a few serious infectious complications and no perioperative deaths. Attention should be paid to low body weight, long surgical and extracorporeal circulation time, and intubation time in relation to infectious complications.
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References
Sengupta A, Murthy RA (2020) Congenital tracheal stenosis and associated cardiac anomalies: operative management and techniques. J Thorac Dis 12:1184–1193. https://doi.org/10.21037/jtd.2019.10.42
Zhang H, Wang S, Lu Z, Zhu L, Du X, Wang H, Xu Z (2017) Slide tracheoplasty in 81 children: improved outcomes with modified surgical technique and optimal surgical age. Medicine 96:e8013. https://doi.org/10.1097/MD.0000000000008013
Manning PB, Rutter MJ, Lisec A, Gupta R, Marino BS (2011) One slide fits all: the versatility of slide tracheoplasty with cardiopulmonary bypass support for airway reconstruction in children. J Thorac Cardiovasc Surg 141:155–161. https://doi.org/10.1016/j.jtcvs.2010.08.060
Chiu PP, Kim PC (2006) Prognostic factors in the surgical treatment of congenital tracheal stenosis: a multicenter analysis of the literature. J Pediatr Surg 41:221–225. https://doi.org/10.1016/j.jpedsurg.2005.10.043 (discussion 221)
Elliott M, Hartley BE, Wallis C, Roebuck D (2008) Slide tracheoplasty. Curr Opin Otolaryngol Head Neck Surg 16:75–82. https://doi.org/10.1097/MOO.0b013e3282f45ab7
Li X, Cheng LC, Cheung YF, Lun KS, Chau KT, Chiu SW (2010) Management of symptomatic congenital tracheal stenosis in neonates and infants by slide tracheoplasty: a 7-year single institution experience. Eur J Cardio Thorac Surg 38:609–614. https://doi.org/10.1016/j.ejcts.2010.03.011
Niitsuma T, Kusachi S, Takesue Y, Mikamo H, Asai K, Watanabe M (2019) Current status of postoperative infections after digestive surgery in Japan: the Japan Postoperative Infectious Complications Survey in 2015. Ann Gastroenterol Surg 3:276–284. https://doi.org/10.1002/ags3.12236
National Healthcare Safety Network, Centers for Disease Control and Prevention. Surgical site infection (SSI) event. http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. Accessed 16 May 2021
Waterlow JC (1972) Classification and definition of protein-calorie malnutrition. Br Med J 3:566–569. https://doi.org/10.1136/bmj.3.5826.566
Bennett JE (2004) Antifungal agents. In: Mandell GL (ed) Mabdell, Douglas and Bennett’s principles and practice of infectious diseases, vol 1, 6th edn. Churchill livingstone, Philadelphia, pp 845–857
Yokoi A, Hasegawa T, Oshima Y, Higashide S, Nakatani E, Kaneda H, Kawamoto A, Nishijima E (2018) Clinical outcomes after tracheoplasty in patients with congenital tracheal stenosis in 1997–2014. J Pediatr Surg 53:2140–2144. https://doi.org/10.1016/j.jpedsurg.2017.12.017
Kurz A, Sessler DI, Lenhardt R (1996) Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 334:1209–1215. https://doi.org/10.1056/NEJM199605093341901
Okamoto T, Nishijima E, Maruo A, Yokoi A, Takamizawa S, Satoh S, Oshima Y (2009) Congenital tracheal stenosis: the prognostic significance of associated cardiovascular anomalies and the optimal timing of surgical treatment. J Pediatr Surg 44:325–328. https://doi.org/10.1016/j.jpedsurg.2008.10.080
Katayanagi T (2015) Nasal methicillin-resistant S. aureus is a major risk for mediastinitis in pediatric cardiac surgery. Ann Thorac Cardiovasc Surg 21:37–44. https://doi.org/10.5761/atcs.oa.14-00157
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Conceptualization, Methodology, Formal analysis, Investigation and Writing: YF, KM; Supervision: SO, MK, TH.
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Fujieda, Y., Morita, K., Otake, S. et al. Infectious complications after tracheoplasty for congenital tracheal stenosis: a retrospective comparative study. Pediatr Surg Int 37, 1737–1741 (2021). https://doi.org/10.1007/s00383-021-04996-x
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DOI: https://doi.org/10.1007/s00383-021-04996-x