Опухоли головы и шеи. 2020; 10: 47-54
Пункционная трахеостомия при опухолях головы и шеи: обзор литературы и анализ собственного опыта
https://doi.org/10.17650/2222-1468-2020-10-1-47-54Аннотация
Введение. Пациенты с опухолями головы и шеи зачастую нуждаются в трахеостомии. Данная манипуляция – сложное хирургическое пособие, несущее риск осложнений, в том числе опасных для жизни.
Цель исследования – оценить результаты выполнения пункционной трахеостомии с использованием нового устройства SafeTrach.
Материалы и методы. В исследование включен 21 пациент. У всех пациентов была выполнена трахеостомия с использованием устройства SafeTrach.
Результаты. Среднее время, затрачиваемое на выполнение процедуры, составило 11,8 ± 3,4 мин и не коррелировало с индексом массы тела и видом предшествующего лечения (r = 0,08, p = 0,7 и r = 0,08, p = 0,73 соответственно). Из всех возможных осложнений трахеостомии лишь в 1 (4,7 %) случае развилось кровотечение в послеоперационном периоде.
Заключение. Описанная методика объединяет в себя все преимущества открытой и пункционной трахеостомии, характеризуется простотой выполнения, не требует эндоскопического контроля, что указывает на целесообразность ее широкого внедрения.
Список литературы
1. Злокачественные новообразования в России в 2017 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена, 2018. 250 с. Доступно по: http://www.oncology.ru/ service/statistics/malignant_tumors/2017. pdf. [Malignant tumors in Russia in 2017 (morbidity and mortality). Ed. by A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow: MNIOI im. P.A. Gertzena, 2018. 250 p. (In Russ.) Available at: http://www.oncology.ru/service/statistics/ malignant_tumors/2017.pdf].
2. Hathiram B.T., Rai R., Watve P., Khattar V.C. Tracheostomy in head and neck cancers. Otorhinolaryngol Clin 2010;2(1):53–60. DOI: 10.5005/jp-journals-10003-1017.
3. Dougherty T.B., Nguyen D.T. Anesthetic management of the patient scheduled for head and neck cancer surgery. J Clin Anesth 1994;6(1):74–82. DOI: 10.1016/0952-8180(94)90125-2.
4. Паршин В.Д. Трахеостомия: показания, техника, осложнения и их лечение. М.: Гэотар-медиа, 2008. 173 с. [Parshin V.D. Tracheostomy: indications, technique, complications and their treatment. Moscow: Geotar-Media, 2008. 173 p. (In Russ.)].
5. Gupta K., Mandlik D., Patel D. et al. Clinical assessment scoring system for tracheostomy (CASST) criterion: objective criteria to predict pre-operatively the need for a tracheostomy in head and neck malignancies. J Craniomaxillofac Surg 2016;44(9):1310–3. DOI: 10.1016/j.jcms.2016.07.008.
6. Cipriano A., Mao M.L., Hon H.H. et al. An overview of complications associated with open and percutaneous tracheostomy procedures. Int J Crit Illn Inj Sci 2015;5(3): 179–88. DOI: 10.4103/2229-5151.164994.
7. Bradley P.J. Bleeding around a tracheostomy wound: what to consider and what to do? J Laryngol Otol 2009;123(9):952–6. DOI: 10.1017/S002221510900526X.
8. Thoracic trauma and critical care. Ed. by R. Karmy-Jones, A.B. Nathens, E.J. Stern. Boston: Springer Science and Business Media, 2012. 592 p.
9. Simon M., Metschke M., Braune S.A. et al. Death after percutaneous dilatational tracheostomy: a systematic review and analysis of risk factors. Crit Care 2013;17(5):R258. DOI: 10.1186/cc13085.
10. Mirza S., Cameron D.S. The tracheostomy tube change: a review of techniques. Hosp Med 2001;62(3):158–63. DOI: 10.12968/hosp.2001.62.3.1536.
11. Bernard A.C., Kenady D.E. Conventional surgical tracheostomy as the preferred method of airway management. J Oral Maxillofac Surg 1999;57(3):310–5. DOI: 10.1016/s0278-2391(99)90679-1.
12. Rajendram R., Khan M.F., Joseph A. Tracheostomy tube displacement: an update on emergency airway management. Ind J Respir Care 2017;6:800. DOI: 10.4103/ijrc.ijrc_12_17.
13. Ahuja H., Mathai A.S., Chander R., Mathew A.E. Case of difficult tracheostomy tube insertion: a novel yet simple solution to the dilemma. Anesth Essays Res 2013;7(3):402–4. DOI: 10.4103/0259-1162.123272.
14. Deganello A., Sofra M.C., Facciolo F., Spriano G. Tracheotomy-related posterior tracheal wall rupture, trans-tracheal repair. Acta Otorhinolaryngol Ital 2007;27(5):258–62.
15. Ullman J., Karling J., Margolin G. A new safe and cost-effective percutaneous dilatational tracheotomy: SafeTrach. Acta Otolaryngol 2016;136(6):598–605. DOI: 10.3109/00016489.2016.1139746.
16. Madsen K., Guldager H., Rewers M. et al. Guidelines for percutaneous dilatational tracheostomy (PDT) from Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM). Dan Med Bull 2011;58(12):C4358.
17. Batuwitage B., Webber S., Glossop A. Percutaneous tracheostomy. Contin Educ Anaesth Crit Care Pain 2014;14:268–72.
18. Klotz R., Probst P., Deininger M. et al. Percutaneous versus surgical strategy for tracheostomy: a systematic review and meta-analysis of perioperative and postoperative complications. Langenbecks Arch Surg 2018;403(2):137–49. DOI: 10.1007/s00423-017-1648-8.
19. Margolin G., Ullman J., Karling J. A new technique for percutaneous tracheotomy. Otolaryngol Head Neck Surg 2017;156(5):966–8. DOI: 10.1177/0194599817697047.
Head and Neck Tumors (HNT). 2020; 10: 47-54
Percutaneous dilatational tracheostomy in patients with head and neck tumors: literature review and institutional experience
https://doi.org/10.17650/2222-1468-2020-10-1-47-54Abstract
Introduction. Patients with head and neck tumors are often require tracheostomy. This procedure represents complex surgical manipulation and is associated with risk of certain complications, including life-threatening.
The study objective is to essess the results of percutaneous tracheostomy with the new SafeTrach technique.
Materials and methods. The study included 21 patients. All patients had a tracheostomy performed using the SafeTrach technique.
Results. Mean duration of tracheostomy with SafeTrach technique was 11.8 ± 3.4 minutes independently of patients’ body mass index or previous treatment (correlation coefficients r = 0.08, p = 0.7 and r = 0.08, p = 0.73, respectively). Among all possible complications of tracheostomy only 1 (4.7 %) case of bleeding in postoperative period was noted in our study.
Conclusion. The SafeTrach technique combines all the benefits of open and percutaneous tracheostomy. It is characterized by simplicity, it does not require endoscopic control, that indicates the feasibility of its widespread implementation.
References
1. Zlokachestvennye novoobrazovaniya v Rossii v 2017 godu (zabolevaemost' i smertnost'). Pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoi. M.: MNIOI im. P.A. Gertsena, 2018. 250 s. Dostupno po: http://www.oncology.ru/ service/statistics/malignant_tumors/2017. pdf. [Malignant tumors in Russia in 2017 (morbidity and mortality). Ed. by A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow: MNIOI im. P.A. Gertzena, 2018. 250 p. (In Russ.) Available at: http://www.oncology.ru/service/statistics/ malignant_tumors/2017.pdf].
2. Hathiram B.T., Rai R., Watve P., Khattar V.C. Tracheostomy in head and neck cancers. Otorhinolaryngol Clin 2010;2(1):53–60. DOI: 10.5005/jp-journals-10003-1017.
3. Dougherty T.B., Nguyen D.T. Anesthetic management of the patient scheduled for head and neck cancer surgery. J Clin Anesth 1994;6(1):74–82. DOI: 10.1016/0952-8180(94)90125-2.
4. Parshin V.D. Trakheostomiya: pokazaniya, tekhnika, oslozhneniya i ikh lechenie. M.: Geotar-media, 2008. 173 s. [Parshin V.D. Tracheostomy: indications, technique, complications and their treatment. Moscow: Geotar-Media, 2008. 173 p. (In Russ.)].
5. Gupta K., Mandlik D., Patel D. et al. Clinical assessment scoring system for tracheostomy (CASST) criterion: objective criteria to predict pre-operatively the need for a tracheostomy in head and neck malignancies. J Craniomaxillofac Surg 2016;44(9):1310–3. DOI: 10.1016/j.jcms.2016.07.008.
6. Cipriano A., Mao M.L., Hon H.H. et al. An overview of complications associated with open and percutaneous tracheostomy procedures. Int J Crit Illn Inj Sci 2015;5(3): 179–88. DOI: 10.4103/2229-5151.164994.
7. Bradley P.J. Bleeding around a tracheostomy wound: what to consider and what to do? J Laryngol Otol 2009;123(9):952–6. DOI: 10.1017/S002221510900526X.
8. Thoracic trauma and critical care. Ed. by R. Karmy-Jones, A.B. Nathens, E.J. Stern. Boston: Springer Science and Business Media, 2012. 592 p.
9. Simon M., Metschke M., Braune S.A. et al. Death after percutaneous dilatational tracheostomy: a systematic review and analysis of risk factors. Crit Care 2013;17(5):R258. DOI: 10.1186/cc13085.
10. Mirza S., Cameron D.S. The tracheostomy tube change: a review of techniques. Hosp Med 2001;62(3):158–63. DOI: 10.12968/hosp.2001.62.3.1536.
11. Bernard A.C., Kenady D.E. Conventional surgical tracheostomy as the preferred method of airway management. J Oral Maxillofac Surg 1999;57(3):310–5. DOI: 10.1016/s0278-2391(99)90679-1.
12. Rajendram R., Khan M.F., Joseph A. Tracheostomy tube displacement: an update on emergency airway management. Ind J Respir Care 2017;6:800. DOI: 10.4103/ijrc.ijrc_12_17.
13. Ahuja H., Mathai A.S., Chander R., Mathew A.E. Case of difficult tracheostomy tube insertion: a novel yet simple solution to the dilemma. Anesth Essays Res 2013;7(3):402–4. DOI: 10.4103/0259-1162.123272.
14. Deganello A., Sofra M.C., Facciolo F., Spriano G. Tracheotomy-related posterior tracheal wall rupture, trans-tracheal repair. Acta Otorhinolaryngol Ital 2007;27(5):258–62.
15. Ullman J., Karling J., Margolin G. A new safe and cost-effective percutaneous dilatational tracheotomy: SafeTrach. Acta Otolaryngol 2016;136(6):598–605. DOI: 10.3109/00016489.2016.1139746.
16. Madsen K., Guldager H., Rewers M. et al. Guidelines for percutaneous dilatational tracheostomy (PDT) from Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM). Dan Med Bull 2011;58(12):C4358.
17. Batuwitage B., Webber S., Glossop A. Percutaneous tracheostomy. Contin Educ Anaesth Crit Care Pain 2014;14:268–72.
18. Klotz R., Probst P., Deininger M. et al. Percutaneous versus surgical strategy for tracheostomy: a systematic review and meta-analysis of perioperative and postoperative complications. Langenbecks Arch Surg 2018;403(2):137–49. DOI: 10.1007/s00423-017-1648-8.
19. Margolin G., Ullman J., Karling J. A new technique for percutaneous tracheotomy. Otolaryngol Head Neck Surg 2017;156(5):966–8. DOI: 10.1177/0194599817697047.
