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Eur J Cardiothorac Surg ; 43(5): 934-9, 2013 May.
Article in English | MEDLINE | ID: mdl-22991458

ABSTRACT

OBJECTIVES: When the T-tube is inserted as a temporary stent, it is unclear whether keeping it longer in place has any benefit on the outcome. METHODS: Among 1738 patients with airway stenosis (1996-2011), 134 underwent T-tube placement (mean duration = 14.3 months); temporarily while waiting for an appropriate time for surgery in 53 (Group 1), as an adjunct after a complex laryngotracheal resection in 27 (Group 2), after surgical failure in 43 (Group 3) and permanently in 11 unresectable strictures (Group 4). A logistic regression model was used for statistical analysis. RESULTS: Seventy percent of patients were males (age = 33.6 ± 17 years). The main cause was postintubation/post-tracheostomy stenosis in 87% of patients. The stenosis (29.6 ± 14 mm, 5-80 mm) was located in the subglottis in 33%, trachea in 47% and both in 20% of cases. To assess the effect of T-tubes on stabilizing the airway after decannulation, 50 patients who still had a T-tube at the end of follow-up or for <1.5 months were excluded. Of the remaining 84, 31.5, 91.5 and 32.5% of patients in Groups 1, 2 and 3 were stable at least 3 months after decannulation. Moreover, 70% of those who were decannulated at or before 6 months and 53.7% of those who were decannulated after 6 months underwent another intervention (P = 0.17). The age, sex, cause, site of stenosis and even duration of T-tube insertion (P = 0.07) showed no significant effect on the decannulation outcome. CONCLUSIONS: Although it seems that keeping the T-tube in place for >6 months may increase the chance of successful decannulation, it was not confirmed in our study.


Subject(s)
Airway Management/instrumentation , Airway Management/methods , Stents , Tracheal Stenosis/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Airway Extubation/instrumentation , Airway Extubation/methods , Chi-Square Distribution , Child , Device Removal , Female , Humans , Intubation, Intratracheal/instrumentation , Intubation, Intratracheal/methods , Logistic Models , Male , Middle Aged , Risk Factors , Tracheal Stenosis/prevention & control , Tracheostomy/instrumentation , Tracheostomy/methods , Treatment Outcome
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