Clinical outcomes of tracheoesophageal diversion and laryngotracheal separation in neurologically impaired children

Objective: Outcomes of tracheoesophageal diversion and laryngotracheal separation were evaluated in 15 neurologically impaired children treated for intractable aspiration.
Methods: A retrospective analysis of the hospital records was carried out in 15 consecutive pediatric patients who underwent either tracheoesophageal diversion or laryngotracheal separation with trumpet-shaped tracheotomy from 1999 to 2006 in Kagawa Children’s Hospital.
Results: The number of hospital admissions for aspiration pneumonia after surgery was significantly decreased in 6 patients who were cared for at home. The parent-reported number of secretion suctioning was decreased after surgery especially in patients with pre-operative tracheotomy or intubation. Four patients fed through naso-gastric tube progressed with oral diet post-operatively, whereas 3 patients who had pre-operative tracheotomy developed temporary post-operative tracheocutaneous fistula that was managed by local wound care.
Conclusion: It is suggested that tracheoesophageal diversion and laryngotracheal separation decrease the morbidity of pediatric patients and improve their quality of life and that of their parents. It is suggested that the risk of developing post-operative fistula is higher in pediatric patients with than without pre-operative tracheotomy.

内容要旨・審査要旨・論文本文の公開
内容要旨・審査要旨 : LID201403051002.pdf
論文本文 : k2657_fulltext.pdf
本論文は，著者Izumi Chidaの学位論文として提出され，学位審査・授与の対象となっている。
著者の申請により要約(2014-05-23公開)に替えて論文全文を公開(2019-12-17)

© 2012 Elsevier Ireland Ltd. All rights reserved.