2021 Volume 12 Issue 1 Pages 9-14
Objective: We investigated the outcomes of patients who underwent tracheotomy and how possible it was for closure of the tracheal stoma to occur. On the basis of these results, we highlighted points to note during surgery.
Methods: The subjects were 204 patients who underwent tracheotomy in our department between April 2010 and March 2015. Patients were classified into 6 categories according to the primary disease: head and neck disease, cranial nerve disease, cardiovascular disease, digestive disease, respiratory disease, and other disease.
Results: Outcome after tracheotomy in the 204 patients was as follows: 81 (39.7%) were discharged, 89 (43.6%) were referred to other hospitals, and 34 (16.7%) died. Patients with head and neck disease had the highest rates of stomal closure at discharge. Furthermore, the median interval until closure of the stoma in these patients was also significantly shorter than that in patients with non-head and neck disease. However, patients with cranial nerve disease had the highest rate of the tracheal stoma remaining open when referred to a rehabilitation hospital. Mortality rates for patients undergoing tracheotomy for cardiovascular, gastrointestinal, and respiratory diseases were high at 50.0% (11/22), 36.8% (7/19), and 26.7% (4/15), respectively.
Conclusion: When long-term airway management is required, such as in cranial nerve disease, tracheal fenestration should be performed with the aim of preventing granulation and tracheal stoma stenosis. Perioperative management must be strict, especially when performing tracheotomy in patients with cardiovascular, gastrointestinal, and respiratory diseases.
