Thesis etd-10252021-135323 |
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Thesis type
Tesi di specializzazione (5 anni)
Author
BACCHIN, DIANA
URN
etd-10252021-135323
Thesis title
Trattamento chirurgico delle stenosi tracheali durante la pandemia da SARS-CoV2 e confronto con l'esperienza precedente.
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
CHIRURGIA TORACICA
Supervisors
relatore Prof. Lucchi, Marco
Keywords
- Covid-19
- resezione/anastomosi tracheale
- SARS-CoV2.
- stenosi tracheale
- tracheal stenosis
- tracheal surgery
Graduation session start date
05/11/2021
Availability
Withheld
Release date
05/11/2091
Summary
Tracheal stenosis is a life-threatening condition, often secondary to invasive mechanical ventilation, which needs multidisciplinary management in referral centers. Tracheal resection with primary end-to-end anastomosis (R/A) is a valid therapeutic option although related to a challenging post-operative care. During the SARS-CoV2 pandemic, the large use of invasive mechanical ventilation determined a marked increase of post-intubation or post-tracheostomy stenosis requiring surgical treatment.
Data of those patients operated on for tracheal stenosis in our tertiary referral Center during the pandemic were collected, analyzed, and compared with previous series.
In the biennium 2020-2021, 11 patients underwent tracheal R/A. All benign stenosis were iatrogenic complications of mechanical ventilation. Six(75%) patients had previously been affected by severe respiratory failure due to SARS-CoV2 pneumonia. There were no differences between patients who have had Covid-19 and patients who did not, regarding intra-and postoperative outcomes. At the endoscopic exam in 30th postoperative day no anastomosis complication was detected.
Prevention of SARS CoV2 diffusion is fundamental to avoid the rise of tracheal stenosis incidence. However, although tracheal R/A still remains a complex surgical procedure with potentially high morbidity rates, it has proved to be safe and effective even in the more challenging subset of Covid-19 patients, in referral high-volume Centers.
Data of those patients operated on for tracheal stenosis in our tertiary referral Center during the pandemic were collected, analyzed, and compared with previous series.
In the biennium 2020-2021, 11 patients underwent tracheal R/A. All benign stenosis were iatrogenic complications of mechanical ventilation. Six(75%) patients had previously been affected by severe respiratory failure due to SARS-CoV2 pneumonia. There were no differences between patients who have had Covid-19 and patients who did not, regarding intra-and postoperative outcomes. At the endoscopic exam in 30th postoperative day no anastomosis complication was detected.
Prevention of SARS CoV2 diffusion is fundamental to avoid the rise of tracheal stenosis incidence. However, although tracheal R/A still remains a complex surgical procedure with potentially high morbidity rates, it has proved to be safe and effective even in the more challenging subset of Covid-19 patients, in referral high-volume Centers.
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