Literature DB >> 33015647

Commentary: Coronavirus disease 2019 (COVID-19) and the airway: How can surgery help?

Erino Angelo Rendina1, Giulio Maurizi1.   

Abstract

Entities:  

Year:  2020        PMID: 33015647      PMCID: PMC7521344          DOI: 10.1016/j.xjtc.2020.09.026

Source DB:  PubMed          Journal:  JTCVS Tech        ISSN: 2666-2507


× No keyword cloud information.
Laryngotracheal anastomotic reconstruction. Surgery could definitely be helpful for many patients presenting with benign subglottic stenosis after COVID-19. The best timing for tracheal resection after SARS-CoV-2 recovery should be defined. See Article page 360. We have read with interest the paper from Lucchi and colleagues reporting on one case of laryngotracheal resection for benign stenosis in a patient post-coronavirus disease 2019 (COVID-19); this is certainly one of the first reports in this setting. The Pisa University team has done a very good job in such a demanding condition. Moreover, this paper offers the opportunity to learn more about COVID-19 and related airway diseases; also, it gives us important insights about the role of surgery in this setting. The first interesting aspect is that what the authors have described might be more and more frequent over the next months or years. In fact, a large number of cases of benign tracheal stenosis is eventually expected because of the prolonged intubation and/or tracheostomy performed to manage the severe respiratory impairment occurring in many patients with COVID-19. The authors reported the presence of a process of coagulative necrosis in the tissue of the resected airway (documented at the pathologic examination), thus confirming the recently published literature that points out the systemic effect of the COVID-19 that sometimes leads to multiorgan involvement. Interestingly, the authors did not report any additional technical difficulty related to this specific condition compared with a laryngotracheal reconstruction performed in a standard situation. Conversely, we experienced very hard and peculiar inflammatory tissues that persisted in the peritracheal area during the dissection and the following airway reconstruction when we recently performed tracheal reconstruction with success in 4 patients who just recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; postintubation stenosis in 2 cases and tracheoesophageal fistula in other 2 cases). These operations were all extremely technically demanding. Based on this limited experience, we cannot provide conclusive recommendations. Nevertheless, we are convinced that a study should be conducted to better investigate and define the best timing for tracheal resection after SARS-CoV-2 recovery. There is no doubt that we are facing a new disease causing an entirely new set of disorders that must still be fully understood. COVID-19 will probably be a problem for a long time. Surgery could definitely be helpful for many patients post-COVID-19, but at the right time and with a very careful or cautious approach. An unpredictable scenario has happened, and we have no other choice than learn with experience to further define how surgery can be helpful in patients who have or had SARS-CoV-2.
  2 in total

1.  Long-term results of laryngotracheal resection for benign stenosis from a series of 109 consecutive patients.

Authors:  Antonio D'Andrilli; Giulio Maurizi; Claudio Andreetti; Anna Maria Ciccone; Mohsen Ibrahim; Camilla Poggi; Federico Venuta; Erino Angelo Rendina
Journal:  Eur J Cardiothorac Surg       Date:  2016-01-19       Impact factor: 4.191

2.  Laryngotracheal resection for a post-tracheotomy stenosis in a patient with coronavirus disease 2019 (COVID-19).

Authors:  Marco Lucchi; Marcello Ambrogi; Vittorio Aprile; Alessandro Ribechini; Gabriella Fontanini
Journal:  JTCVS Tech       Date:  2020-08-13
  2 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.