Tracheal Resection - State of the Art

Maassen, W; Greschuchna, D; Vogt-Moykopf, I.; Toomes, H.; Lüllig, H

doi:10.1055/s-2007-1014071

Cited by 34 publications

(16 citation statements)

References 3 publications

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“…[27] The definitive treatment of benign tracheal stenosis remains tracheal reconstruction surgery. [28] However, surgery could not be performed in our patients both because of lack of surgical expertise and unwillingness of the patients. Five rigid bronchoscopy procedures were performed for foreign body removal of which four were successful.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

et al. 2014

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Background and Aim:Rigid bronchoscopy is often an indispensable procedure in the therapeutic management of a wide variety of tracheobronchial disorders. However, it is performed at only a few centers in adult patients in India. Herein, we report our initial 1-year experience with this procedure.Materials and Methods:A prospective observational study on the indications, outcomes, and safety of various rigid bronchoscopy procedures performed between November 2009 and October 2010. Improvement in dyspnea, cough, and the overall quality of life was recorded on a visual analog scale from 0 to 100 mm. A systematic review of PubMed was performed to identify studies reporting the use of rigid bronchoscopy from India.Results:Thirty-eight rigid bronchoscopies (50 procedures) were performed in 19 patients during the study period. The commonest indication was benign tracheal stenosis followed by central airway tumor, and the procedures performed were rigid bronchoplasty, tumor debulking, and stent placement. The median procedure duration was 45 (range, 30-65) min. There was significant improvement in quality of life associated with therapeutic rigid bronchoscopy. Minor procedural complications were encountered in 18 bronchoscopies, and there was no procedural mortality. The systematic review identified 15 studies, all on the role of rigid bronchoscopy in foreign body removal.Conclusions:Rigid bronchoscopy is a safe and effective modality for treatment of a variety of tracheobronchial disorders. There is a dire need of rigid bronchoscopy training at teaching hospitals in India.

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Section: Discussionmentioning

confidence: 99%

Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

et al. 2014

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“…[14][15][16] In this series, seven patients with tracheal and tracheosubglottic stenotic lesions were resected with no mortality; an improvement over the results of Arola et al and Maassen et al, who reported mortality rates of 18% and 19% consequently. 17,18 Postoperatively, two complications were noted: ventilation for three weeks in one patient, and moderate anastomotic restenosis in the other. Excessive anastomotic tension is without doubt the single most important cause of failure in tracheal surgery.…”

Section: Discussionmentioning

confidence: 97%

Surgery for Postintubation Tracheal and Tracheosubglottic Stenotic Lesions

et al. 1996

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Postintubation tracheal stenosis is a recognized problem. Although its incidence has recently decreased, it is still a difficult complication to treat. We have reviewed our experience with 10 patients with tracheal stenosis over the last five years between 1990 and 1995. There were seven male and three female patients with an average age of 14.2±4 years (range 6 to 48 years). Resection and reconstruction with primary anastomosis was performed in seven patients, while conservative treatment with dilatation was performed in two patients. One patient refused surgery. Operations performed included resection of tracheocricoid segment with tracheothyroid anastomosis (N=3) and tracheal resection with end-to-end anastomosis (N=4). The resected airway segment ranged from 3 cm to 6 cm. In view of the intense inflammatory and fibrotic process in and around the stenotic segment, the practice of tracheostomy for the relief of postintubation acute tracheal obstruction should not be taken lightly, as it adds not only to the severity of the inflammatory process, but also increases the length of the tracheal segment to be resected. Postoperatively, all patients were extubated; this was accomplished by the end of surgery in six patients, while the seventh patient was extubated three weeks later. There was no mortality in this series. When normal functional activity and airway patency were taken as two parameters to judge the outcome of surgery, results were good in six (86%) patients and satisfactory in one. These results support the validity of the one-stage reconstruction approach as one alternative for the treatment of postintubation tracheal and tracheosubglottic stenotic lesions.

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“…The more permanent treatment is still open surgery such as end-toend anastomosis. Unfortunately the procedure is more suitable for defect less then 6 cm in length and the longer the segment it will create tension and granulation tissue formation [1][2][3]. However, for defects larger then the above measurement, reconstruction by grafts, slide tracheoplasty and prostheses need to be used.…”

Section: Introductionmentioning

confidence: 99%