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Infectious complications after tracheoplasty for congenital tracheal stenosis: a retrospective comparative study

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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

  1. 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

    Article  PubMed  PubMed Central  Google Scholar 

  2. 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

    Article  PubMed  PubMed Central  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. 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)

    Article  PubMed  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. 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

    Article  Google Scholar 

  7. 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

    Article  PubMed  PubMed Central  Google Scholar 

  8. 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

  9. 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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. 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

    Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This research received no specific Grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Kobe Children’s Hospital, 1-6-7, Minatojima Minami-cho, Chuo-ku, Kobe, 650-0047, Japan

    Yuki Fujieda, Keiichi Morita & Tadashi Hatakeyama

  2. Division of Infectious Disease, Department of Pediatrics, Kobe Children’s Hospital, Kobe, Japan

    Shogo Otake & Masashi Kasai

Authors
  1. Yuki Fujieda
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  2. Keiichi Morita
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  3. Shogo Otake
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  4. Masashi Kasai
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  5. Tadashi Hatakeyama
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Contributions

Conceptualization, Methodology, Formal analysis, Investigation and Writing: YF, KM; Supervision: SO, MK, TH.

Corresponding author

Correspondence to Yuki Fujieda.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study has been approved by the institutional ethics committee (approval number: R2-20) and performed in line with the principles of the Declaration of Helsinki.

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This study was open to the public and guaranteed a refusal to cooperate; the data were anonymous, and the need for a separate informed consent was waived.

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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

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