Reoperative tracheal resection and reconstruction for unsuccessful repair of postintubation stenosis
Objective: Our objective was to analyze characteristics and results of redo tracheal resection and reconstruction. Methods: Seventy-five patients were operated on between 1966 and 1997 after unsuccessful initial repairs for postintubation tracheal stenosis. Results: Sixteen of these patients came fr...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 1997-12, Vol.114 (6), p.934-939 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Donahue, Dean M. Grillo, Hermes C. Wain, John C. Wright, Cameron D. Mathisen, Douglas J. |
| description | Objective: Our objective was to analyze characteristics and results of redo tracheal resection and reconstruction.
Methods: Seventy-five patients were operated on between 1966 and 1997 after unsuccessful initial repairs for postintubation tracheal stenosis.
Results: Sixteen of these patients came from a group of 32 patients with unsuccessful repair among the 450 primary resections and reconstructions performed at our institution. Fifty-nine patients were referred to us after unsuccessful initial repair elsewhere. Initial management was a T-tube or tracheotomy in 39 patients. The length of repeat resection ranged from 1.0 cm to 5.5 cm (mean 3.5 cm). A laryngeal release was used in 19 patients (25%) to reduce anastomotic tension. Complications occurred in 29 patients (39%) and were most frequent in the group requiring laryngeal release (12/19, 63.2%). Overall outcome was good in 59 patients (78.6%) and satisfactory in 10 (13.3%). The repair was unsuccessful in four patients (5.3%), and two patients died (2.6%).
Conclusions: Despite difficulties encountered in reoperative surgery after failed tracheal reconstruction for postintubation stenosis, successful outcome may be achieved in a large number of cases. (J Thorac Cardiovasc Surg 1997;114:934-9) |
| doi_str_mv | 10.1016/S0022-5223(97)70007-2 |
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Methods: Seventy-five patients were operated on between 1966 and 1997 after unsuccessful initial repairs for postintubation tracheal stenosis.
Results: Sixteen of these patients came from a group of 32 patients with unsuccessful repair among the 450 primary resections and reconstructions performed at our institution. Fifty-nine patients were referred to us after unsuccessful initial repair elsewhere. Initial management was a T-tube or tracheotomy in 39 patients. The length of repeat resection ranged from 1.0 cm to 5.5 cm (mean 3.5 cm). A laryngeal release was used in 19 patients (25%) to reduce anastomotic tension. Complications occurred in 29 patients (39%) and were most frequent in the group requiring laryngeal release (12/19, 63.2%). Overall outcome was good in 59 patients (78.6%) and satisfactory in 10 (13.3%). The repair was unsuccessful in four patients (5.3%), and two patients died (2.6%).
Conclusions: Despite difficulties encountered in reoperative surgery after failed tracheal reconstruction for postintubation stenosis, successful outcome may be achieved in a large number of cases. (J Thorac Cardiovasc Surg 1997;114:934-9)</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/S0022-5223(97)70007-2</identifier><identifier>PMID: 9434688</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Adult ; Anastomosis, Surgical - methods ; Female ; Humans ; Intubation, Intratracheal - adverse effects ; Male ; Postoperative Complications - epidemiology ; Reoperation ; Trachea - surgery ; Tracheal Stenosis - etiology ; Tracheal Stenosis - surgery ; Treatment Failure</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 1997-12, Vol.114 (6), p.934-939</ispartof><rights>1997 Mosby, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-df6ccf4700be6348261195f4ecf7a0cc41b1976861112300b52bc89ef8d295bf3</citedby><cites>FETCH-LOGICAL-c505t-df6ccf4700be6348261195f4ecf7a0cc41b1976861112300b52bc89ef8d295bf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-5223(97)70007-2$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9434688$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Donahue, Dean M.</creatorcontrib><creatorcontrib>Grillo, Hermes C.</creatorcontrib><creatorcontrib>Wain, John C.</creatorcontrib><creatorcontrib>Wright, Cameron D.</creatorcontrib><creatorcontrib>Mathisen, Douglas J.</creatorcontrib><creatorcontrib>From the General Thoracic Surgical Unit, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, Mass</creatorcontrib><title>Reoperative tracheal resection and reconstruction for unsuccessful repair of postintubation stenosis</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective: Our objective was to analyze characteristics and results of redo tracheal resection and reconstruction.
Methods: Seventy-five patients were operated on between 1966 and 1997 after unsuccessful initial repairs for postintubation tracheal stenosis.
Results: Sixteen of these patients came from a group of 32 patients with unsuccessful repair among the 450 primary resections and reconstructions performed at our institution. Fifty-nine patients were referred to us after unsuccessful initial repair elsewhere. Initial management was a T-tube or tracheotomy in 39 patients. The length of repeat resection ranged from 1.0 cm to 5.5 cm (mean 3.5 cm). A laryngeal release was used in 19 patients (25%) to reduce anastomotic tension. Complications occurred in 29 patients (39%) and were most frequent in the group requiring laryngeal release (12/19, 63.2%). Overall outcome was good in 59 patients (78.6%) and satisfactory in 10 (13.3%). The repair was unsuccessful in four patients (5.3%), and two patients died (2.6%).
Conclusions: Despite difficulties encountered in reoperative surgery after failed tracheal reconstruction for postintubation stenosis, successful outcome may be achieved in a large number of cases. (J Thorac Cardiovasc Surg 1997;114:934-9)</description><subject>Adult</subject><subject>Anastomosis, Surgical - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Intubation, Intratracheal - adverse effects</subject><subject>Male</subject><subject>Postoperative Complications - epidemiology</subject><subject>Reoperation</subject><subject>Trachea - surgery</subject><subject>Tracheal Stenosis - etiology</subject><subject>Tracheal Stenosis - surgery</subject><subject>Treatment Failure</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF2L1TAQhoMo63H1Jyz0yo-LapImbXMlsvgFC4If4F1IpxNPlp6mZtIV_705p4e99SrMzPMmmYexK8FfCy7aN984l7LWUjYvTfeq45x3tXzAdoKbrm57_fMh290jj9kTotsjw4W5YBdGNart-x0bv2JcMLkc7rDKycEe3VQlJIQc4ly5eSwVxJlyWreWj6laZ1oBkMivR3pxIVXRV0ukHOa8Du5EUsY5UqCn7JF3E-Gz83nJfnx4__36U33z5ePn63c3NWiucz36FsCrssqAbaN62QphtFcIvnMcQIlBmK7tS1vIplBaDtAb9P0ojR58c8meb_cuKf5ekbI9BAKcJjdjXMl2RkvVaV1AvYGQIlFCb5cUDi79tYLbo117smuP6qzp7MmulSV3dX5gHQ443qfOOsv8xTbfh1_7PyGhpYObpkILe5uBhFC2taZRhXy7kVh83AVMliDgDDiWFGQ7xvCfv_wDI0eZww</recordid><startdate>19971201</startdate><enddate>19971201</enddate><creator>Donahue, Dean M.</creator><creator>Grillo, Hermes C.</creator><creator>Wain, John C.</creator><creator>Wright, Cameron D.</creator><creator>Mathisen, Douglas J.</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19971201</creationdate><title>Reoperative tracheal resection and reconstruction for unsuccessful repair of postintubation stenosis</title><author>Donahue, Dean M. ; Grillo, Hermes C. ; Wain, John C. ; Wright, Cameron D. ; Mathisen, Douglas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-df6ccf4700be6348261195f4ecf7a0cc41b1976861112300b52bc89ef8d295bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Anastomosis, Surgical - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Intubation, Intratracheal - adverse effects</topic><topic>Male</topic><topic>Postoperative Complications - epidemiology</topic><topic>Reoperation</topic><topic>Trachea - surgery</topic><topic>Tracheal Stenosis - etiology</topic><topic>Tracheal Stenosis - surgery</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Donahue, Dean M.</creatorcontrib><creatorcontrib>Grillo, Hermes C.</creatorcontrib><creatorcontrib>Wain, John C.</creatorcontrib><creatorcontrib>Wright, Cameron D.</creatorcontrib><creatorcontrib>Mathisen, Douglas J.</creatorcontrib><creatorcontrib>From the General Thoracic Surgical Unit, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, Mass</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Donahue, Dean M.</au><au>Grillo, Hermes C.</au><au>Wain, John C.</au><au>Wright, Cameron D.</au><au>Mathisen, Douglas J.</au><aucorp>From the General Thoracic Surgical Unit, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston, Mass</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reoperative tracheal resection and reconstruction for unsuccessful repair of postintubation stenosis</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>1997-12-01</date><risdate>1997</risdate><volume>114</volume><issue>6</issue><spage>934</spage><epage>939</epage><pages>934-939</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Objective: Our objective was to analyze characteristics and results of redo tracheal resection and reconstruction.
Methods: Seventy-five patients were operated on between 1966 and 1997 after unsuccessful initial repairs for postintubation tracheal stenosis.
Results: Sixteen of these patients came from a group of 32 patients with unsuccessful repair among the 450 primary resections and reconstructions performed at our institution. Fifty-nine patients were referred to us after unsuccessful initial repair elsewhere. Initial management was a T-tube or tracheotomy in 39 patients. The length of repeat resection ranged from 1.0 cm to 5.5 cm (mean 3.5 cm). A laryngeal release was used in 19 patients (25%) to reduce anastomotic tension. Complications occurred in 29 patients (39%) and were most frequent in the group requiring laryngeal release (12/19, 63.2%). Overall outcome was good in 59 patients (78.6%) and satisfactory in 10 (13.3%). The repair was unsuccessful in four patients (5.3%), and two patients died (2.6%).
Conclusions: Despite difficulties encountered in reoperative surgery after failed tracheal reconstruction for postintubation stenosis, successful outcome may be achieved in a large number of cases. (J Thorac Cardiovasc Surg 1997;114:934-9)</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>9434688</pmid><doi>10.1016/S0022-5223(97)70007-2</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Anastomosis, Surgical - methods Female Humans Intubation, Intratracheal - adverse effects Male Postoperative Complications - epidemiology Reoperation Trachea - surgery Tracheal Stenosis - etiology Tracheal Stenosis - surgery Treatment Failure |
| title | Reoperative tracheal resection and reconstruction for unsuccessful repair of postintubation stenosis |
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