Tracheal resection with primary anastomosis: 10 years experience

Am J Otolaryngol. 2009 Nov-Dec;30(6):415-8. doi: 10.1016/j.amjoto.2008.08.008. Epub 2009 Mar 26.

Abstract

Objective: The aim of the study was to review clinical, imagiologic, and surgical outcomes of tracheal resection in the management of laryngotracheal stenosis.

Methods: The study used a retrospective analysis of adult patients managed in a tertiary academic hospital who underwent thyrotracheal, cricotracheal, or tracheal end-to-end anastomosis between 1997 and 2006.

Results: Twelve patients, aged 15 to 79 years old, were included. Prolonged tracheal intubation was the leading cause of stenosis (11 patients) that was classified according to Myer-Cotton (Ann Otol Rhinol Laryngol. 1994;103:319-323) classification as follows: grade II (25%), grade III (58%), and grade IV (17%). The stenosis extension ranged from 1 to 6 cm. Surgeries varied from tracheal end-to-end anastomosis (n = 5), cricotracheal anastomosis (n = 4), and thyrotracheal anastomosis (n = 3). Extubation was achieved in 11 patients (92%). One patient maintains a T tube stent. The most common complication was the presence of granulation tissue in the anastomosis region (33%). There was no mortality associated.

Conclusions: Tracheal resection with primary anastomosis appears to be a successful and safe procedure mainly due to its high decannulation rate and few complications associated.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical*
  • Cricoid Cartilage / surgery
  • Female
  • Humans
  • Intubation, Intratracheal
  • Laryngostenosis / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Thyroid Cartilage / surgery
  • Trachea / surgery
  • Tracheal Stenosis / surgery*
  • Tracheotomy
  • Treatment Outcome
  • Young Adult