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Learning Curve for Translaryngeal Tracheotomy in Head and Neck Surgery
- Source :
- The Laryngoscope. 111:628-633
- Publication Year :
- 2001
- Publisher :
- Wiley, 2001.
-
Abstract
- Objectives Translaryngeal tracheotomy (TLT) is a widely accepted procedure in intensive-care units for its simplicity of execution, low morbidity, rapid wound closure after cannula removal, good esthetic results, and lack of long-term sequelae. The aim of this study was to evaluate the feasibility and use of adopting TLT in patients with cancer undergoing major head and neck surgery. Study Design Prospective analysis of learning curve and incidence of complications in 41 patients with cancer who underwent TLT at the Division of Head and Neck Surgery of the European Institute of Oncology from November 1997 to June 1999. Methods Patient characteristics, pathology, anatomic characteristics of the neck, and surgical short-term and long-term complications were noted. The patients were divided into consecutive groups of six or seven patients, and time trends in occurrence of complications and time to execute the procedure were assessed. Results TLT performance time decreased from 50 minutes in the first seven patients to 24 minutes in the last group. The technique was easy to perform and safe, with only two minor complications during surgery. However, minor complications occurred in three and major complications in 17 patients in the days immediately following surgery, almost entirely attributable to lack of counter-cannu1a and stylet. Conclusions In view of the high proportion of major complications, TLT using the presently available kit is unsuitable for major head and neck surgery. However, the considerable advantages of the technique would recommend it as a valid alternative to surgical tracheotomy if the kit included a counter-cannu1a and stylet.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Postoperative Complications
Tracheotomy
Humans
Medicine
Prospective Studies
Major complication
Intraoperative Complications
business.industry
Incidence (epidemiology)
Head and neck cancer
Middle Aged
medicine.disease
Cannula
Surgery
Stylet
Oropharyngeal Neoplasms
Otorhinolaryngology
Epidermoid carcinoma
Head and Neck Neoplasms
Practice, Psychological
Head and neck surgery
Feasibility Studies
Female
Mouth Neoplasms
Clinical Competence
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 0023852X
- Volume :
- 111
- Database :
- OpenAIRE
- Journal :
- The Laryngoscope
- Accession number :
- edsair.doi.dedup.....e46cb67d57fa6de64dbeec3d1b669031