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European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 5, pp 1545–1548 | Cite as

Laryngo-tracheal resections in the Nordic countries: an option for further centralization?

  • Tejs Ehlers KlugEmail author
  • Malene Hentze
  • Sten Schytte
  • Lovisa Farnebo
  • Oddveig Rikardsen
  • Eero Sihvo
  • Jari Räsänen
  • Antti Mäkitie
Short Communication

Abstract

Purpose

We aimed to obtain information on the number of Nordic centers performing tracheal resections, crico-tracheal resections, and laryngo-tracheal reconstructions, as well as the patient volume and the standard regimens associated with these procedures.

Methods

Consultants at all Departments of Otorhinolaryngology—Head and Neck Surgery (ORL-HNS, n = 22) and Thoracic Surgery (n = 21) in the five Nordic countries were invited (April 2018—January 2019) to participate in an online survey.

Results

All 43 departments responded to the survey. Twenty departments declared to perform one or more of the three types of tracheal resections. At five hospitals, departments of ORL-HNS and Thoracic Surgery perform these operations in collaboration. Hence, one or more of the tracheal operations in question are carried out at 15 centers. The median annual number of tracheal operations per center is five (range 1–20). Great variations were found regarding contraindications (relative and absolute) for surgery, the use of guardian sterno-mental sutures (all patients, 33%; selected cases, 40% of centers), prophylactic antibiotic therapy (cefuroxime +/− metronidazole, penicillin +/− metronidazole, clindamycin, imipenem, or none), post-operative follow-up time (range: children: 3–120 months; adults: 0–60 months), and the performance of post-operative bronchoscopy.

Conclusions

Fifteen centers each perform a low number of annual operations with significant variations in the selection of patients and the clinical setup, which raises the question if a higher degree of collaboration and centralization would be warranted. We encourage Nordic transnational collaboration, pursuing alignment on central management issues, and establishment of a common prospective database for future tracheal resection surgery.

Keywords

Tracheal resection Crico-tracheal resection Management Nordic countries 

Notes

Compliance with ethical standards

Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

According to Danish law, no ethical approval is necessary in questionnaire studies.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryAarhus University HospitalAarhus NDenmark
  2. 2.Department of Otolaryngology in LinköpingAnaesthetics, Operations and Specialty Surgery CenterLinköpingSweden
  3. 3.Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation ScienceLinköping UniversityLinköpingSweden
  4. 4.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of North Norway, and University of Tromsø-The Arctic University of NorwayTromsøNorway
  5. 5.Department of SurgeryCentral Finland Central HospitalJyvaskylaFinland
  6. 6.Department of General Thoracic and Esophageal SurgeryHelsinki University HospitalHelsinkiFinland
  7. 7.Department of Surgery, ClinicumUniversity of HelsinkiHelsinkiFinland
  8. 8.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
  9. 9.Research Programme in Systems Oncology, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
  10. 10.Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and TechnologyKarolinska Institutet and Karolinska HospitalStockholmSweden

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