OBJECTIVETo compare the indications and therapeutic effects of several invasive interventions in treating postoperative sputum retention.

METHODSBronchoscopy, cricothyroidotomy, intubation or tracheotomy was performed in 112 patients with postoperative sputum retention from January 2002 to December 2006. There were 95 male and 17 female patients. The age ranged from 14- to 81-years-old with a mean of (65.2 +/- 11.1) years old. Their clinical data were collected to prove the improvement of PaO2, SpO2, and pulmonary atelectasis. Sputum clearance results of these invasive methods were compared as well.

RESULTSBronchoscopies were effective in 24 out of 60 cases (40.0%), while the rest 36 cases called for multiple bronchoscopies or other maneuvers. Tracheal intubations were effective in 31.2% (15/48) patients, among whom 11 patients required further cricothyroidotomies, and 22 patients required tracheotomies. Intubations and bronchoscopies resulted shorter intervention durations and efficacy durations, comparing with the other two methods.

CONCLUSIONSPersonalized risk analysis helps decision making in invasive interventions for postoperative sputum clearance. Tracheal intubations and bronchoscopic clearance are helpful in short-term symptomatic relief and recommended the first choice in cases of postoperative sputum retentions.