Partial cricotracheal resection for severe upper tracheal stenosis: Potential impacts on the outcome

El-Fattah, Ahmed Musaad Abd; Ebada, Hisham Atef; Amer, H E; Abo-Samra, Mohammed; Tawfik, Ali

doi:10.1016/j.anl.2017.03.014

Cited by 13 publications

(17 citation statements)

References 36 publications

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“…In our series, RLN palsy was seen in four patients (9%) after LTR and in two patients (4%) after STR-ETE. Our results are comparable with findings in other reported series, where RLN palsy is found in 2% to 13% of patients after (laryngo)tracheal surgery (20,23,24). On the other hand, voice alterations without RLN palsy were reported twice as much after LTR when compared to STR-ETE (34% versus 16%, P=0.034).…”

Section: Discussionsupporting

confidence: 90%

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Timman¹,

Schoemaker²,

Li³

et al. 2018

Ann. Cardiothorac. Surg.

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Background: In this study we focus on functional outcomes after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis, with a specific interest in the impact of laryngeal involvement on postoperative outcome.Methods: All patients who underwent (laryngo)tracheal surgery for benign pathology between 1996 and 2017 in our centre were included in this retrospective study. Surgical outcomes were procedural success rate, and airway-and voice-related complications. Functional results were assessed using (standardized) questionnaires for quality of life, sensation of dyspnea, swallowing function, and voice perception.Results: Of 119 consecutive patients, 47 underwent laryngotracheal resection and reconstruction and 72 underwent segmental tracheal surgery (78% with an end-to-end tracheal anastomosis and 22% with a cricotracheal anastomosis). Overall success rate was 92% and was similar for all groups, with an overall significant improvement in quality of life when compared to the preoperative situation. However, after laryngotracheal surgery, airway-related complications were more common when compared to segmental resections with an end-to-end tracheal anastomosis (30% versus 7%, P=0.003). Additionally, early voice alterations without recurrent nerve palsy were reported twice as often (34% versus 16%, P=0.034) and voice quality experienced during follow-up was significantly worse when compared to segmental resections.Overall response rate to the questionnaires on functional outcome was 63%.Conclusions: (Laryngo)tracheal surgery is safe and beneficial, with significant functional improvement during mid-and long-term follow-up. However, laryngeal involvement is a predictor for increased surgical airway-related complications. Additionally, voice alterations without recurrent nerve palsy are far more common after laryngotracheal resection and are a serious handicap. This aspect is underexposed in current literature and deserves further attention during preoperative counseling and patient follow-up. However, the results on functional outcome of this current study should be interpreted with caution due to the somewhat low response rate of the questionnaires.

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Section: Discussionsupporting

confidence: 90%

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Timman¹,

Schoemaker²,

Li³

et al. 2018

Ann. Cardiothorac. Surg.

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“…Resection of long airway segment (more than 3.5 cm) had poorer outcome in many previous reports. 10,21,28 The longer the resection, the more tension will be on the anastomosis, with higher incidence of anastomotic complications as dehiscence, granulation tissue formation and ultimately less favourable outcome. In the present work, the resected airway segment in the Surgiflo group was significantly longer than that of the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Previous open airway interventions were one of the poor prognostic factors in many studies. 21,29 Previous unsuccessful laryngotracheoplasty be costal cartilage or other methods is associated with more damage, fibrosis and scarring of the airway skeleton. On the other hand, performing a revision surgery after previous unsuccessful airway resection leads to longer resected segment, with greater tension on the anastomosis and higher incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, the authors adopted the surgical techniques described by Grillo 16,17 and Monnier, 18,19 and was published in 2011 20 and 2018. 21 Table 1 shows the difference between Surgiflo group and control group regarding demographic data, comorbidities, preoperative tracheotomy, previous airway interventions, grade of stenosis, length of resected airway segment and type of anastomosis.…”

Section: Patients and Me Thodsmentioning

confidence: 99%

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Surgiflo^® may have a potential impact on the healing process in cricotracheal resection anastomosis

El-Fattah

Ebada

Tawfik

2020

Clinical Otolaryngology

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“…15 In a study involving 52 cases, Mohsen and colleagues 16 observed that resection of 4 cm was well-tolerated after laryngeal release, with only one-third of patients showing mild dysphagia and phonation dysfunction, which disappeared within 3 weeks of surgery. El-Fattah and colleagues 17 noted that the length of the resection was negatively related to the success of tracheal resection/anastomosis. However, they observed that partial cricotracheal resection and tracheal resection/anastomosis was the best option for rectifying posttraumatic subglottic and upper tracheal stenosis.…”

Section: Discussionmentioning

confidence: 99%

Effect of resected length in reconstructive surgery for tracheobronchial injury

Vũ

Khanh

Nguyễn

et al. 2019

Asian Cardiovasc Thorac Ann

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Background Mechanical injury to the trachea and bronchi may cause mild to severe stenosis requiring surgical intervention for reconstructing the damaged trachea. The location, length, and cause of injury are important factors affecting the surgical outcome. Method We conducted a retrospective study to evaluate the results of reconstructive surgery on noncancerous tracheobronchial lesions in 75 patients aged 5–55 years who had undergone reconstructive tracheobronchial surgery in our hospital from 2009 to 2018. Results The causes of tracheobronchial injury included blunt trauma in 38 patients, sharp penetrating trauma in 24, a postintubation lesion in 6, a post-tracheotomy lesion in 3, tuberculosis in 3, and an adult congenital lesion in one. In 59 cases of a lesion in the trachea, the length of missing segment before reconnection was 1–2 cm in 6 cases, 3 cm in 22, 4 cm in 18, 5 cm in 13, and >5.5 cm in 1 case. The length of the resected segment was <5.5 cm in all survivors, whereas one death occurred when the resected length was approximately 6 cm. Conclusions The length of the resected segment and precision of the surgery are crucial for determining the outcome of surgery.

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Partial cricotracheal resection for severe upper tracheal stenosis: Potential impacts on the outcome

Cited by 13 publications

References 36 publications

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Surgiflo^® may have a potential impact on the healing process in cricotracheal resection anastomosis

Effect of resected length in reconstructive surgery for tracheobronchial injury

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Partial cricotracheal resection for severe upper tracheal stenosis: Potential impacts on the outcome

Cited by 13 publications

References 36 publications

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Functional outcome after (laryngo)tracheal resection and reconstruction for acquired benign (laryngo)tracheal stenosis

Surgiflo® may have a potential impact on the healing process in cricotracheal resection anastomosis

Effect of resected length in reconstructive surgery for tracheobronchial injury

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Surgiflo^® may have a potential impact on the healing process in cricotracheal resection anastomosis