Surgical treatment of severe benign tracheal stenosis.

Humans Tracheal Stenosis / surgery Constriction, Pathologic / complications Retrospective Studies Trachea / surgery Larynx / surgery Anastomosis, Surgical / adverse effects Treatment Outcome
Benign stenosis Surgical treatment Trachea

Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
14 Oct 2023
Historique:
received: 25 03 2023
accepted: 26 09 2023
medline: 23 10 2023
pubmed: 14 10 2023
entrez: 14 10 2023
Statut: epublish

Résumé

To present clinical experiences regarding surgical treatment of patients with severe cicatricial tracheal stenosis. From January 2008 to March 2020, 14 patients underwent tracheal resection and reconstruction under general anesthesia. Nine cases had cervical tracheal stenosis and five cases had thoracic tracheal stenosis. The mean diameter and length of strictured trachea was 0 - 8 mm with a mean of 4.5 ± 2.4 mm and 1 - 3 cm with a mean of 1.67 ± 0.63 cm, respectively. General anesthesia and mechanical ventilation were performed in ten cases and four patients underwent femoral arteriovenous bypass surgery due to severe stenosis. End-to-end anastomosis of trachea was performed in 13 cases and the anastomosis between trachea and cricothyroid membrane was performed in one case. Absorbable and unabsorbable sutures were used for the anterior and posterior anastomoses, respectively. Postoperative neck anteflexion was maintained by a suture between the chin and superior chest wall. The relevant data of the 14 patients were retrospectively reviewed, and the operation time, blood loss, postoperative hospital stay, postoperative complications and follow-up were retrieved. There was no intraoperative death. The length of resected trachea ranged from 1.5 to 4.5 cm with a mean of 1.67 ± 0.63 cm. Operation time ranged from 50 - 450 min with a mean of 142.8 ± 96.6 min and intraoperative hemorrhage ranged from 10 - 300 ml with a mean of 87.8 ± 83.6 ml. Follow-up period ranged from 5 to 43 months with a mean of 17.9 ± 10.6 months. None of the patients had recurrent laryngeal nerve paralysis during postoperative follow-up. Ten cases were discharged uneventfully. Anastomosis stenosis occurred in three cases who received interventional therapies. Bronchopleurocutaneous fistula occurred in one patient after 6 days postoperatively and further treatment was declined. The strategies of anesthesia, mechanical ventilation, identification of stenosis lesion, the "hybrid" sutures and postoperative anteflexion are critical to be optimized for successful postoperative recovery.

Identifiants

DOI: 10.1186/s13019-023-02369-0 PMID: 37833733 PMC: PMC10576339
pubmed: 37833733
doi: 10.1186/s13019-023-02369-0
pii: 10.1186/s13019-023-02369-0
pmc: PMC10576339
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

293

Subventions

Organisme : Natural Science Foundation of Chongqing City
ID : grant no. cstc2018jcyjAX0592

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Yong-Geng Feng (YG)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China.

Shao-Lin Tao (SL)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China.

Long-Yong Mei (LY)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China.

Fu-Qiang Dai (FQ)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China.

Qun-You Tan (QY)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China.

Ru-Wen Wang (RW)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China.

Jing-Hai Zhou (JH)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China. zhzhlu1993@aliyun.com.

Bo Deng (B)

Thoracic Surgery Department, Institute of Surgery Research, Daping Hospital, Army Medical University, Changjiang Branch St, 10#, Yuzhong District, Chongqing city, 400042, China. dengbo@tmmu.edu.cn.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › Maladies de l'appareil respiratoire › Maladie de la trachée › Sténose trachéale › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Sténose pathologique › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › Appareil respiratoire › Trachée › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › Appareil respiratoire › Larynx › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › Procédures de chirurgie opératoire › Anastomose chirurgicale › Surgical treatment of severe benign tracheal stenosis.
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Surgical treatment of severe benign tracheal stenosis.