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Risk Factors Associated with Post-Operative Complications in Multidisciplinary Treatment of Descending Necrotizing
Maria Teresa Congedo1,2, Dania Nachira1,2, Mariano Alberto Pennisi2,3
1Unit of Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
Journal of Clinical Medicine
|November 11, 2022
Summary
Descending necrotizing mediastinitis (DNM) requires prompt surgical drainage. Age over 60 and cervical-only approaches are risk factors for complications, suggesting minimally invasive techniques may improve outcomes.
Area of Science:
- Thoracic Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Descending necrotizing mediastinitis (DNM) is a severe complication of oropharyngeal infections.
- DNM presents with cervical necrotizing fasciitis and can be life-threatening.
Purpose of the Study:
- To identify factors correlating with favorable outcomes in patients with DNM.
- To analyze risk factors for post-operative complications in DNM patients.
Main Methods:
- Retrospective analysis of 18 patients surgically treated for DNM.
- Review of patient demographics, symptoms, comorbidities, surgical procedures, and outcomes.
Main Results:
- Age ≥ 60 years, cervicotomy alone, and bilateral approaches were significant risk factors for post-operative complications.
- Thoracotomy + cervicotomy was the most common surgical procedure.
Conclusions:
- Extensive and immediate surgical drainage of the neck and mediastinum is crucial for reducing DNM mortality.
- Cervical drainage alone may increase complication risk; minimally invasive approaches like Uniportal-VATS may benefit elderly patients and those requiring bilateral access.
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