Airway surgery is performed for COVID-19 patients who require long-term tracheal intubation and mechanical ventilation. Tracheostomy sometimes causes postoperative complications represented by bleeding at a relatively high rate in COVID-19 patients. As an alternative surgical procedure to tracheostomy, cricotracheostomy may reduce these complications, but few studies have examined its safety. Data were retrospectively collected for sixteen COVID-19 patients (11 underwent tracheostomy, 5 underwent modified cricotracheostomy). In addition to patients’ backgrounds and blood test data, the frequency of complications and additional care required for postoperative complications were collected. Statistical analysis was conducted by the univariate analysis of Fischer analysis and Mann–Whitney U test. Five cases experienced postoperative bleeding, four cases experienced peristomal infection, and one case experienced subcutaneous emphysema in the tracheostomy patients. These complications were not observed in the cricotracheostomy patients. The number of additional cares for postoperative complications was significantly lower in cricotracheostomy than in tracheostomy patients ( < 0.05). Modified cricotracheostomy could be a safe procedure in airway surgery for patients with COVID-19 from the point of fewer postoperative complications and additional care. It might be necessary to select the cricotracheostomy depending on patients’ background to reduce postoperative complications.

中文翻译：

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使用皮肤和气管膜瓣进行环气管切开术治疗重症 COVID-19 患者的安全性

气道手术是针对需要长期气管插管和机械通气的COVID-19患者进行的。气管切开术有时会导致术后并发症，以出血率相对较高的方式治疗 COVID-19 患者。作为气管切开术的替代外科手术，环气管切开术可能会减少这些并发症，但很少有研究检验其安全性。回顾性收集了 16 名 COVID-19 患者的数据（11 名患者接受了气管切开术，5 名患者接受了改良环气管切开术）。除了患者的背景和血液检测数据外，还收集了并发症的发生频率以及术后并发症所需的额外护理。通过Fischer分析和Mann-Whitney U检验的单变量分析进行统计分析。气管切开患者术后出血5例，造口周围感染4例，皮下气肿1例。在环气管切开术患者中未观察到这些并发症。环切气管切开术后并发症的额外护理次数明显低于气管切开患者（<0.05）。从术后并发症较少和额外护理的角度来看，改良环气管切开术可能是 COVID-19 患者气道手术的一种安全手术。可能有必要根据患者的背景选择环气管切开术，以减少术后并发症。