Tirbod Fattahi1, Christopher Chafin2, Anthony Bunnell3. 1. Chair, Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL. Electronic address: Tirbod.Fattahi@Jax.Ufl.Edu. 2. Chief Resident, Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL. 3. Fellow in Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL.
Abstract
PURPOSE: This study evaluated the difficulties and challenges associated with open tracheostomy in the morbidly obese patient (body mass index [BMI] ≥30 kg/m2). PATIENTS AND METHODS: Forty patients met all the inclusion criteria. A retrospective chart review was performed to evaluate indications for tracheostomy, duration of intubation before tracheostomy, history of tracheostomy, duration of operative procedure, duration in the operating room, and all perioperative complications. RESULTS: Complications were classified as intraoperative (5%) and postoperative (17.5%). The average BMI was 46 kg/m2 (range, 31.1 to 75.3 kg/m2). The average duration of intubation before tracheostomy was 11 days. Ten patients (25%) previously underwent tracheostomy. The average operating time was 60 minutes (range, 20 to 95 minutes). The average total time in the operating room was 100 minutes (range, 45 to 146 minutes). CONCLUSION: This study shows that although open tracheostomy in the morbidly obese patient is increasing in demand, the procedure can be predictably performed albeit at a much longer duration and a higher perioperative complication rate compared with the traditional tracheostomy.
PURPOSE: This study evaluated the difficulties and challenges associated with open tracheostomy in the morbidly obesepatient (body mass index [BMI] ≥30 kg/m2). PATIENTS AND METHODS: Forty patients met all the inclusion criteria. A retrospective chart review was performed to evaluate indications for tracheostomy, duration of intubation before tracheostomy, history of tracheostomy, duration of operative procedure, duration in the operating room, and all perioperative complications. RESULTS: Complications were classified as intraoperative (5%) and postoperative (17.5%). The average BMI was 46 kg/m2 (range, 31.1 to 75.3 kg/m2). The average duration of intubation before tracheostomy was 11 days. Ten patients (25%) previously underwent tracheostomy. The average operating time was 60 minutes (range, 20 to 95 minutes). The average total time in the operating room was 100 minutes (range, 45 to 146 minutes). CONCLUSION: This study shows that although open tracheostomy in the morbidly obesepatient is increasing in demand, the procedure can be predictably performed albeit at a much longer duration and a higher perioperative complication rate compared with the traditional tracheostomy.
Authors: Erik Stenberg; Luiz Fernando Dos Reis Falcão; Mary O'Kane; Ronald Liem; Dimitri J Pournaras; Paulina Salminen; Richard D Urman; Anupama Wadhwa; Ulf O Gustafsson; Anders Thorell Journal: World J Surg Date: 2022-01-04 Impact factor: 3.352