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Partial laryngotracheal resection and anastomosis, institutional 10 years’ experience

Abstract

Objective

This study aimed to evaluate the results of partial laryngotracheal resection and anastomosis in the management of iatrogenic laryngotracheal stenosis.

Patients and Methods

This retrospective analytical study was conducted on all patients who had been operated by means of partial laryngotracheal resection and anastomosis in our institute, from 2004 to 2014. The period of follow-up was at least 1 year. The total number of the patients included was 22.

Results

Successful decanulation was achieved in 20 (90.9%) cases. The number of complicated cases in our study (with one or more complication) was eight (36.3%). Two cases complained of dyspnea with documented restenosis of the trachea, and one case died from severe hemoptysis at 12 days postoperatively, most probably from trauma of the innominate. Two cases were complicated by surgical emphysema and one case was complicated by hematoma; all of them were managed successfully.

Conclusion

Partial laryngotracheal resection and anastomosis is a safe and reliable surgical method for the management of grade III and IV iatrogenic laryngotracheal stenosis. This technique achieves best results in male patients when the stenosis is short segment, and not involving the cricoid cartilage.

References

  1. 1

    Wain JC Jr. Postintubation tracheal stenosis. Semin Thorac Cardiovasc Surg 2009; 21:284–289.

    Article  Google Scholar 

  2. 2

    Kastanos N, Estopá Miró R, Marín Perez A, Xaubet Mir A, Agustí-Vidal A. Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Crit Care Med 1983; 11:362–367.

    CAS  PubMed  Google Scholar 

  3. 3

    Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med 1981; 70: 65–76.

    CAS  PubMed  Google Scholar 

  4. 4

    Monnier P. Subglottic and tracheal stenosis. In: Remacle M, Eckel H, editors. Surgery of larynx and trachea. Berlin, Heidelberg: Springer; 2009. pp. 137–158.

    Google Scholar 

  5. 5

    Yamamoto K, Kojima F, Tomiyama K, Nakamura T, Hayashino Y. Meta-analysis of therapeutic procedures for acquired subglottic stenosis in adults. Ann Thorac Surg 2011; 91:1747–1753.

    Article  Google Scholar 

  6. 6

    Bibas BJ, Terra RM, Junior AL, Tamagno MF, Minamoto H, Cardoso PF, Pêgo-Fernandes PM. Predictors for postoperative complications after tracheal resection. Ann Thorac Surg 2014; 98:277–282.

    Article  Google Scholar 

  7. 7

    Myer CM, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994; 103:319–323.

    Article  Google Scholar 

  8. 8

    Lano CF Jr, Duncavage JA, Reinisch L, Ossoff RH, Courey MS, Netterville JL. Laryngotracheal reconstruction in the adult: a ten year experience. Ann Otol Rhinol Laryngol 1998; 107:92–97.

    Article  Google Scholar 

  9. 9

    Marulli G, Rizzardi G, Bortolotti L, Loy M, Breda C, Hamad AM, et al. Single-staged laryngotracheal resection and reconstruction for benign strictures in adults✩. Interact Cardiovasc Thorac Surg 2008; 7:227–230.

    Article  Google Scholar 

  10. 10

    Dedo HH, Fishman NH. The results of laryngeal release, tracheal mobilization and resection for tracheal stenosis in 19 patients. Laryngoscope 1973; 83:1204–1210.

    CAS  Article  Google Scholar 

  11. 11

    Nandakumar R, Jagdish C, Prathibha CB, Shilpa C, Sreenivas V, Balasubramanya AM, Nayar RC. Tracheal resection with end-to-end anastomosis for post-intubation cervical tracheal stenosis: study of 14 cases. J Laryngol Otol 2011; 125:958–961.

    CAS  Article  Google Scholar 

  12. 12

    Marques P, Leal L, Spratly J, Cardoso E, Santos M. Tracheal resection with primary anastomosis: 10 years experience. Am J Otolaryngol 2009; 30: 415–418.

    Article  Google Scholar 

  13. 13

    Biller HG, Munier MA. Combined infrahyoid and inferior constrictor muscle release for tension-free anastomosis during primary tracheal repair. Otolaryngol Head Neck Surg 1992; 107:430–433.

    CAS  Article  Google Scholar 

  14. 14

    Har-el G, Shaha A, Chaudry R, Lucente FE. Resection of tracheal stenosis with end-to-end anastomosis. Ann Otol Rhinol Larynol 1993; 102:670–674.

    CAS  Article  Google Scholar 

  15. 15

    Laccourreye O, Naudo P, Brasnu D, Jouffre V, Cauchois R, Laccourreye H. Tracheal resection with end-to-end anastomosis for isolated postintubation cervical tracheal stenosis: long term results. Ann Otol Rhinol Laryngol 1996; 105:944–948.

    CAS  Article  Google Scholar 

  16. 16

    Wynn R, Har-El G, Lim JW. Tracheal resection with end-to-end anastomosis for benign tracheal stenosis. Ann Otol Rhinol Laryngol 2004; 113:613–617.

    Article  Google Scholar 

  17. 17

    Merati AL, Rieder AA, Patel N, Park DL, Girod D. Does successful segmental tracheal resection require releasing maneuvers? Otolaryngol Head Neck Surg 2005; 133:372–376.

    Article  Google Scholar 

  18. 18

    Grillo HC, Donahue DM, Mathisen DJ, Wain JC, Wright CD. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg 1995; 109:486–492. [discussion 492–493].

    CAS  Article  Google Scholar 

  19. 19

    Rea F, Callegaro D, Loy M, Zuin A, Narne S, Gobbi T, et al. Benign tracheal and laryngotracheal stenosis: surgical treatment and results. Eur J Cardiothorac Surg 2002; 22:352–356.

    Article  Google Scholar 

  20. 20

    Donahue DM, Grillo HC, Wain JC, Wright CD, Mathisen DJ. Reoperative tracheal resection and reconstruction for unsuccessful repair of postintubation stenosis. J Thorac Cardiovasc Surg 1997; 114:934–938. [discussion 938–939].

    CAS  Article  Google Scholar 

  21. 21

    Abbasidezfouli A, Akbarian E, Shadmehr MB, Arab M, Javaherzadeh M, Pejhan S, et al. The etiological factors of recurrence after tracheal resection and reconstruction in post-intubation stenosis. Interact CardioVasc Thorac Surg 2009; 9:446–449.

    Article  Google Scholar 

  22. 22

    El-Fattah AM, Kamal E, Amer HE, Fouda M, Elwahab AE, Tawfik A. Cervical tracheal resection with cricotracheal anastomosis: experience in adults with grade III-IV tracheal stenosis. J Laryngol Otol 2011; 125: 614–619.

    CAS  Article  Google Scholar 

  23. 23

    Wright CD, Grillo HC, Wain JC. Anastomotic complications after tracheal resection: prognostic factors and management. J Thorac Cardiovasc Surg 2004; 128:731–739.

    Article  Google Scholar 

  24. 24

    Negm H, Mosleh M, Fathy H. Circumferential tracheal resection with primary anastomosis for post-intubation tracheal stenosis: study of 24 cases. Eur Arch Otorhinolaryngol 2013; 270:2709–2717.

    Article  Google Scholar 

  25. 25

    Primov-Fever A, Talmi YP, Yellin A, Wolf M. Cricotracheal resection for airway reconstruction: the Sheba medical center experience. Isr Med Assoc J 2006; 8:543–547.

    PubMed  Google Scholar 

  26. 26

    Herrington HC, Weber SM, Andersen PE. Modern management of laryngotracheal stenosis. Laryngoscope 2006; 116:1553–1557.

    Article  Google Scholar 

  27. 27

    Peskind SP, Stanley RB Jr, Thangathurai D. Treatment of the compromised trachea with sleeve resection and primary repair. Laryngoscope 1993; 103:203–211.

    CAS  Article  Google Scholar 

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Correspondence to Yasser A. Fouad MD.

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Mobashir, M., Mohamed, A.E.S., Anani, A. et al. Partial laryngotracheal resection and anastomosis, institutional 10 years’ experience. Egypt J Otolaryngol 34, 132–137 (2018). https://doi.org/10.4103/ejo.ejo_78_16

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Keywords

  • laryngotracheal stenosis
  • partial laryngotracheal resection and anastomosis
  • successful decanulation