Related Experiment Videos
Tracheostomy in childhood: 20 years experience from a pediatric surgery clinic
Zekeriya Ilçe1, Sinan Celayir, Gonca Topuzlu Tekand
1Department of Paediatric Surgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
Insights
Pediatric tracheostomy is a life-saving procedure, but carries significant risks. Careful indication and surgical technique are crucial to minimize complications and improve outcomes for children requiring this intervention.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Critical Care Medicine
Background:
- Tracheostomy in pediatric surgery is infrequently indicated due to prolonged intubation feasibility in children.
- Potential complications and challenges exist with pediatric tracheostomy, even in childhood.
Purpose of the Study:
- To retrospectively evaluate the experience and outcomes of tracheostomy procedures in pediatric patients.
- To analyze indications, complications, and mortality associated with pediatric tracheostomy.
Main Methods:
- Retrospective review of 17 pediatric patients undergoing tracheostomy between 1978 and 1999.
- Analysis of patient records focusing on reasons for tracheostomy, subsequent complications, and mortality rates.
Main Results:
- Indications included prolonged intubation, subglottic stenosis, trauma, and congenital anomalies.
- The overall complication rate was 29%, with a mortality rate of 59%.
- An increase in tracheostomies was observed in the last decade, often performed electively for prolonged ventilation support.
Conclusions:
- Tracheostomy can be life-saving in pediatric patients when performed with appropriate indications and surgical expertise.
- Pediatric surgeons must be aware of potential complications, care challenges, and the need for reconstructive surgery.
- Strict adherence to indications and procedural experience are vital for minimizing tracheostomy-related issues in children.
Background:
There is a limited indication for tracheostomy procedures in pediatric surgery. It is rarely applied to the pediatric patient because they can be kept intubated for a longer duration compared with adults. Problems and complications can occur after tracheostomy, even during the childhood period.
Purpose:
The purpose of this study is to evaluate our experience with tracheostomy procedure.
Methods:
Records of 17 children treated over a 20-year period (1978-99) were reviewed retrospectively in the aspects of indication, complication and mortality.
Results:
There were 13 boys and four girls with a mean age 30.3 months (range: 1 week-13 years). Indications for tracheostomy were prolonged intubation (n = 5), subglottic stenosis (n = 3), general body trauma (n = 2), tracheomalasia (n = 2), tracheoesophageal cleft (n = 1), cervical tumor pressing trachea and larynx (n = 1), congenital myotonic dystrophy plus respiratory failure (n = 1), burn injury of trachea and esophagus (n = 1), and foreign body aspiration (n = 1). In the last decade the number of cases with tracheotomy increased due to the development of new intensive care units, the use of mechanical ventilation and the increasing number of patients needing prolonged ventilation support. In this group, tracheostomies were mainly performed electively. The overall complication rate was 29%. Mortality was 59% and there was one death related to the tracheostomy procedure.
Conclusion:
Tracheostomy is a life saving procedure when performed with an appropriate indication and surgical technique. Therefore, the pediatric surgeons dealing with this procedure should be aware of the tracheostomy care problems, fatal complications and the need for reconstructive surgery. With strict indications and experience of the procedure, this should be enough effort to minimize its complications and related care problems.