Starplasty contributes to reduce tracheostomal granulation in pediatric tracheostomy

Abstract

Background

Starplasty tracheostomy for pediatric patients has been suggested to reduce complications, including accidental decannulation and granulation.

Objectives

This study, based in a single hospital, aims to evaluate whether starplasty tracheostomy decreases the incidence of postoperative granulation of tracheostoma.

Material and methods

A retrospective review was performed of patients that underwent tracheostomy under the age of 10 years in a single center between January 2001 and August 2020.

Results

Of the 46 patients reviewed, 18 were males and 28 were females, and the median age at the initial operation was 6 months. Methods of tracheostomy were starplasty in 16 patients, vertical in 15 patients, horizontal H-shaped in 10 patients, fenestration in 3 patients, and trap door/inverted U-shaped in two patients. During observation, tracheostoma granulation was found in 25 patients and bleeding from tracheostoma occurred in one patient. No other major complications were observed. The incidence of postoperative tracheostoma granulation was significantly lower in patients that underwent starplasty tracheostomy compared with patients that underwent other types of tracheostomy (p = .007). There was no difference in survival outcomes or ratio of decannulations.

Conclusions

Starplasty tracheostomy was shown to decrease the incidence of tracheostoma granulation compared with other types of tracheostomy.

Chinese abstract

背景：建议对儿科患者进行 Starplasty 气管切开术以减少并发症, 包括意外拔管和肉芽形成。

目的：以一家医院为基地, 评估Starplasty气管切开术是否降低气管造口术后肉芽发生率。

材料和方法：对 2001 年 1 月至 2020 年 8 月在一个医疗中心接受气管切开术的 10 岁以下患者进行回顾性研究。

结果：46 例患者中, 男性 18 例, 女性 28 例, 初始手术时的中位年龄为 6 个月。Starplasty气管切开法为16例, 垂直气管切开法15例, 水平 H 形气管切开法 10 例, 开窗 气管切开法3 例, 活板门/倒 U 形气管切开法 2 例。观察期间发现气管造口肉芽25例, 一名患者发生气管造口出血。没有观察到其它主要并发症。与接受其他类型气管切开术的患者相比, 术后气管造口肉芽的发生率在接受Starplasty气管切开术的患者中低得多(p¼ .007)。生存结果或拔管率方面没有差异。

结论：与其它类型的气管切开术相比, Starplasty 气管切开术可降低气管造口肉芽的发生率。

Keywords:

• Pediatric
• tracheostomy
• starplasty
• complication
• granulation

Acknowledgements

We acknowledge proofreading and editing by Benjamin Phillis at the Clinical Study Support Center, Wakayama Medical University.

Author contributions

All authors have read and agreed to the published version of the manuscript.

Institutional review board statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Wakayama Medical University Institutional Ethics Committee (#3017).

Informed consent statement

Informed consent was obtained in the form of an opt-out on the Japanese website.

Disclosure statement

No potential conflict of interest was reported by the author(s).