Tarek Mohsen1, Amany Abou Zeid2, Ihab Abdelfattah1, Mohammed Mosleh3, Waleed Adel1, Ashraf Helal1. 1. Department of Cardiothoracic Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt. 2. Department of Chest Medicine, Kasr Alainy Hospital, Cairo University, Cairo, Egypt. 3. Department of Otolaryngology and Head and Neck Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt.
Abstract
OBJECTIVES: Resection of long-segment trachea is challenging, and although 50% of adult trachea can be removed, anastomotic complications arise proportionally. Different release manoeuvres have been described to gain length and reduce tension at the suture line. The aim of the study was to evaluate the outcome when different release manoeuvres have been utilized during resection and reconstruction of the trachea. METHODS: From January 2005 to December 2015, 52 patients with long segments of trachea ≥40 mm requiring resection and reconstruction were treated at our institute. Demographic, operative and postoperative data were retrospectively analysed. RESULTS: Fifty-two patients with long-segment tracheal disorders ≥40 mm were analysed in this stud. Transient swallowing and phonation dysfunction occurred in 17 (32.2%) patients, exclusively in patients who underwent laryngeal release. Swallowing dysfunction was Grade I in all patients, except 2 who suffered Grade II dysphagia and were relieved in the early postoperative period. Forty-five (86.5%) patients were symptom free, and 7 (13.4%) patients were symptomatic (dyspnoea on exertion and/or stridor) and required reintervention. Four (7.6%) patients responded to 1 or 2 sessions of bronchoscopic dilatation, and 3 patients were left with permanent tracheostomies. Patients with neoplastic pathology were followed up without any neoplastic recurrence. CONCLUSIONS: Long-segment resection and reconstruction of the trachea utilizing one or more release manoeuvres can be safely done, with low complication rates. Although swallowing and phonation dysfunction after laryngeal release were commonly encountered (almost one-third of patients), they were mild, transient, self-limited and recovered within 2-3 weeks of the early postoperative period.
OBJECTIVES: Resection of long-segment trachea is challenging, and although 50% of adult trachea can be removed, anastomotic complications arise proportionally. Different release manoeuvres have been described to gain length and reduce tension at the suture line. The aim of the study was to evaluate the outcome when different release manoeuvres have been utilized during resection and reconstruction of the trachea. METHODS: From January 2005 to December 2015, 52 patients with long segments of trachea ≥40 mm requiring resection and reconstruction were treated at our institute. Demographic, operative and postoperative data were retrospectively analysed. RESULTS: Fifty-two patients with long-segment tracheal disorders ≥40 mm were analysed in this stud. Transient swallowing and phonation dysfunction occurred in 17 (32.2%) patients, exclusively in patients who underwent laryngeal release. Swallowing dysfunction was Grade I in all patients, except 2 who suffered Grade II dysphagia and were relieved in the early postoperative period. Forty-five (86.5%) patients were symptom free, and 7 (13.4%) patients were symptomatic (dyspnoea on exertion and/or stridor) and required reintervention. Four (7.6%) patients responded to 1 or 2 sessions of bronchoscopic dilatation, and 3 patients were left with permanent tracheostomies. Patients with neoplastic pathology were followed up without any neoplastic recurrence. CONCLUSIONS: Long-segment resection and reconstruction of the trachea utilizing one or more release manoeuvres can be safely done, with low complication rates. Although swallowing and phonation dysfunction after laryngeal release were commonly encountered (almost one-third of patients), they were mild, transient, self-limited and recovered within 2-3 weeks of the early postoperative period.
Authors: Anja E Luengen; Maria Cheremkhina; Julian Gonzalez-Rubio; Jan Weckauf; Caroline Kniebs; Hendrik Uebner; E Miriam Buhl; Christian Taube; Christian G Cornelissen; Thomas Schmitz-Rode; Stefan Jockenhoevel; Anja Lena Thiebes Journal: Front Bioeng Biotechnol Date: 2022-06-17