The effect of suture techniques on the outcome of tracheal reconstruction: An observational study and review of literature.


Journal

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
ISSN: 1479-666X
Titre abrégé: Surgeon
Pays: Scotland
ID NLM: 101168329

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 07 11 2021
revised: 23 03 2022
accepted: 31 03 2022
pubmed: 4 5 2022
medline: 15 3 2023
entrez: 3 5 2022
Statut: ppublish

Résumé

Tracheal resection and anastomosis surgery is a safe operation and is used to treat various benign and malignant diseases of the trachea. However, tracheal stenosis is among the main anastomotic complications following this procedure. Surgeons use both the continuous and the interrupted suture techniques for tracheal anastomosis, but contradicting results in each technique's complications have been reported in various studies. In this study, we aimed to compare the outcome of these two different suture techniques and a relevant literature review. Surgical records during a period of 15 years (2005-2019) were screened for tracheal reconstruction surgery in affiliated hospitals of Shiraz University of Medical Sciences, Shiraz, Iran. A total of 82 patients were evaluated based on surgical and suture features, along with their follow-up bronchoscopy for anastomotic complications. Post-operational subclinical restenosis occurred in 8 (15.3%) out of 52 and 10 (33.3%) of 30 patients who underwent continuous and interrupted suturing techniques, respectively. Also, 6 (20%) patients in the interrupted group developed symptomatic restenosis, while in the continuous group, only one patient was clinically symptomatic. The patients with continuous suture technique had a shorter surgery time than patients whose interrupted technique was used (P < 0.001). Based on our results, we conclude that restenosis is significantly reduced when the continuous technique is applied for tracheal anastomosis; However, the results are contradicting in relevant literature and due to the retrospective nature of our study, further human studies and clinical trials are warranted.

Sections du résumé

BACKGROUND BACKGROUND
Tracheal resection and anastomosis surgery is a safe operation and is used to treat various benign and malignant diseases of the trachea. However, tracheal stenosis is among the main anastomotic complications following this procedure. Surgeons use both the continuous and the interrupted suture techniques for tracheal anastomosis, but contradicting results in each technique's complications have been reported in various studies. In this study, we aimed to compare the outcome of these two different suture techniques and a relevant literature review.
METHODS METHODS
Surgical records during a period of 15 years (2005-2019) were screened for tracheal reconstruction surgery in affiliated hospitals of Shiraz University of Medical Sciences, Shiraz, Iran. A total of 82 patients were evaluated based on surgical and suture features, along with their follow-up bronchoscopy for anastomotic complications.
RESULTS RESULTS
Post-operational subclinical restenosis occurred in 8 (15.3%) out of 52 and 10 (33.3%) of 30 patients who underwent continuous and interrupted suturing techniques, respectively. Also, 6 (20%) patients in the interrupted group developed symptomatic restenosis, while in the continuous group, only one patient was clinically symptomatic. The patients with continuous suture technique had a shorter surgery time than patients whose interrupted technique was used (P < 0.001).
CONCLUSIONS CONCLUSIONS
Based on our results, we conclude that restenosis is significantly reduced when the continuous technique is applied for tracheal anastomosis; However, the results are contradicting in relevant literature and due to the retrospective nature of our study, further human studies and clinical trials are warranted.

Identifiants

pubmed: 35504817
pii: S1479-666X(22)00058-0
doi: 10.1016/j.surge.2022.03.008
pii:
doi:

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e89-e96

Informations de copyright

Copyright © 2022 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no competing interests.

Auteurs

Bizhan Ziaian (B)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Reza Shahriarirad (R)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Damoun Fouladi (D)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address: damoun.fld@gmail.com.

Armin Amirian (A)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

Keivan Ranjbar (K)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Mohammadreza Karoobi (M)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Farzaneh Ketabchi (F)

Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Parviz Mardani (P)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Mohammad Javad Fallahi (MJ)

Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Science, Shiraz, Iran; Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

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