Format

Send to

Choose Destination
Auris Nasus Larynx. 2016 Dec;43(6):602-8. doi: 10.1016/j.anl.2016.03.009. Epub 2016 Apr 14.

Treatment of large tracheal defects after resection: Laryngotracheal release and tracheal replacement.

Author information

1
Department of Visceral, Thoracic and Vascular Surgery, Philipp University, Marburg, Germany. Electronic address: Kirschbaum001@gmx.de.
2
Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
3
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain; Fundación de Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain.
4
Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
5
Departments of Surgery and Otolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
6
Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, UK.
7
University of Udine School of Medicine, Udine, Italy.
8
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.
9
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
10
Formerly Director of the Department of Surgical Sciences and Chairman of the ENT Clinic at the University of Udine School of Medicine, Udine, Italy; Coordinator of the International Head and Neck Scientific Group.

Abstract

OBJECTIVE:

Resection with direct tracheal or laryngotracheal anastomosis is the standard procedure employed for treatment of benign stenosis or occasionally primary or secondary tracheal malignancy.

DATA SOURCES:

Literature review.

RESULTS:

A tracheal anastomosis usually heals without complications provided that the ends being joined are adequately supplied with blood, an atraumatic suturing technique is used, and the anastomosis does not become infected. It is especially important that the anastomosis is not subjected to tension.

CONCLUSION:

Various techniques of laryngeal and tracheal release serve to reduce the tension on the anastomosis by mobilizing and reducing the distance between the two segments to be approximated. These techniques can be used in different combinations depending on situation encountered during surgery. In cases where more than 50% of the tracheal length must be excised, prosthetic replacements, autologous tissue transfer and allografts are required. All present various problems. The use of tissue-engineering techniques utilizing autologous stem cells has opened new perspectives for tracheal replacement. Such procedures are still in an experimental state.

KEYWORDS:

Anastomotic tension; Laryngotracheal anastomosis; Tracheal replacement; Tracheal resection

PMID:
27085818
PMCID:
PMC5152768
DOI:
10.1016/j.anl.2016.03.009
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center