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May 1982, Vol 108, No. 5 >
ARTICLE | May 1982

Prevention of Tracheal Stricture in End-to-End Anastomosis FREE

Ulf Nordin, MD, PhD; Lennart Ohlsén, MD, PhD
[+] Author Affiliations

Accepted for publication Oct 28, 1981.

Reprint requests to the Department of Otolaryngology, University Hospital, S-750 14 Uppsala, Sweden (Dr Nordin).


Arch Otolaryngol Head Neck Surg. 1982;108(5):308-314. doi:10.1001/archotol.1982.00790530044011
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References
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• The development of stenosis at the suture line after tracheal resection and end-to-end anastomosis of the trachea is associated with failure to approximate the tracheal ends. Evidently, stenosis invariably will occur if the viable mucosal edges are not properly adapted to each other. We developed a method of anastomosis affording accurate approximation of the tracheal ends and particularly of the mucosa by doing Z-plasties in the mucosa. This method of tracheal anastomosis, which is comparatively easy and safe to perform, may be used reliably and without the development of mucosal strictures.

(Arch Otolaryngol 1982;108:308-314)

REFERENCES

1 +
Grillo HC:  Surgical treatment of postintubation tracheal injuries . J Thorac Cardiovasc Surg 1979;;78:860-875.
2 +
Barclay RS, McSwan N, Welsh TM:  Tracheal reconstruction without the use of grafts . Thorax 1957;;12:177-180.
3 +
Clagett OT, Grindley JH, Moersch HJ:  Resection of the trachea . Arch Surg 1948;;57:253-266.
4 +
Ferguson DJ, Wild JJ, Wangensteen OH:  Experimental resection of the trachea . Surgery 1950;;28:597-619.
5 +
Grillo HC:  Circumferential resection and reconstruction of mediastinal and cervical trachea . Ann Surg 1965;;162:374-388.
6 +
Grillo HC:  Reconstruction of the trachea . Thorax 1973;;28:667-679.
7 +
Grillo HC, Bendiken HH, Gephart T:  Resection of the carina and lower trachea . Ann Surg 1963;;158:889-893.
8 +
Grillo HC, Dignan EF, Miura T:  Extensive resection and reconstruction of mediastinal trachea without prosthesis or graft: An anatomical study in man . J Thorac Cardiovasc Surg 1964;;48:741-749.
9 +
Maisel B, Dingwall JA:  Primary suture of the divided cervical trachea . Surgery 1950;;27:726-729.
10 +
Michelsen E, Solomon R, Mann L, et al:  Experiments in tracheal reconstruction . J Thorac Cardiovasc Surg 1961;;41:748-759.
11 +
Mulliken JB, Grillo HC:  The limits of tracheal resection with primary anastomosis . J Thorac Cardiovasc Surg 1968;;55:418-421.
12 +
Sőm ML, Klein SH:  Primary anastomosis of the trachea after resection of a wide segment . J Mount Sinai Hosp 1958;;35:211-220.
13 +
Stalpaert G, Deneffe G, van Maele R:  Surgical treatment of adenoid cystic carcinoma of the left main bronchus and trachea by left pneumonectomy, resection of 7.5 cm of trachea, and direct reanastomosis of right lung . Thorax 1979;;34:554-556.
14 +
Cantrell JR, Folse JR:  The repair of circumferential defects of the trachea by direct anastomosis: Experimental evaluation . J Thorac Cardiovasc Surg 1961;;42:589-598.
15 +
Jackson TL, Lefkin P, Tuttle W, et al:  An experimental study in bronchial anastomosis . J Thorac Cardiovasc Surg 1949;;18:630-642.
16 +
Kiriluk LB, Merendino KA:  An experimental evaluation in the dog of bronchial transplantation, bronchial, tracheal and tracheobronchial resection with reconstruction . Ann Surg 1953;; 137:490-503.
17 +
Colley F:  Die Resektion der Trachea . Dtsch Z Chir 1895;;40:150-162.
18 +
Pacheco CR, Rivero O, Porter JK:  Experimental reconstructive surgery of the trachea . J Thorac Cardiovasc Surg 1954;;27:554-564.
19 +
McGregor IA: Fundamental Techniques of Plastic Surgery , ed 7. New York, Churchill Livingstone, 1980;.
20 +
Luft JH:  Improvements in epoxy resin embedding methods . J Biophys Biochem Cytol 1961;;9:409-414.
21 +
Anderson TF:  Techniques for the preservation of three-dimensional structure in preparing specimens for the electron microscope . Trans NY Acad Sci 1951;;13:130-134.
22 +
Grover FL, Ellestad C, Arom KV, et al:  Diagnosis and management of major tracheobronchial injuries . Ann Thorac Surg 1979;;28:384-391.
23 +
Pearson FG, Cooper JD, Nelems JM, et al:  Primary tracheal anastomosis after resection of the cricoid cartilage with preservation of recurrent laryngeal nerves . J Thorac Cardiovasc Surg 1975;;70:806-816.
24 +
Tsubota N, Simpson WJ, van Nostrand AW, et al:  The effects of preoperative irradiation of primary tracheal anastomosis . Ann Thorac Surg 1975;;20:152-160.
25 +
Ohlsén L, Nordin U:  Tracheal reconstruction with perichondrial grafts . Scand J Plast Reconstr Surg 1976;;10:135-145.
26 +
Nordin U:  The regeneration of cuff-induced tracheal injuries: An experimental study in rabbits . Acta Otolaryngol , to be published.

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1 +
Grillo HC:  Surgical treatment of postintubation tracheal injuries . J Thorac Cardiovasc Surg 1979;;78:860-875.
2 +
Barclay RS, McSwan N, Welsh TM:  Tracheal reconstruction without the use of grafts . Thorax 1957;;12:177-180.
3 +
Clagett OT, Grindley JH, Moersch HJ:  Resection of the trachea . Arch Surg 1948;;57:253-266.
4 +
Ferguson DJ, Wild JJ, Wangensteen OH:  Experimental resection of the trachea . Surgery 1950;;28:597-619.
5 +
Grillo HC:  Circumferential resection and reconstruction of mediastinal and cervical trachea . Ann Surg 1965;;162:374-388.
6 +
Grillo HC:  Reconstruction of the trachea . Thorax 1973;;28:667-679.
7 +
Grillo HC, Bendiken HH, Gephart T:  Resection of the carina and lower trachea . Ann Surg 1963;;158:889-893.
8 +
Grillo HC, Dignan EF, Miura T:  Extensive resection and reconstruction of mediastinal trachea without prosthesis or graft: An anatomical study in man . J Thorac Cardiovasc Surg 1964;;48:741-749.
9 +
Maisel B, Dingwall JA:  Primary suture of the divided cervical trachea . Surgery 1950;;27:726-729.
10 +
Michelsen E, Solomon R, Mann L, et al:  Experiments in tracheal reconstruction . J Thorac Cardiovasc Surg 1961;;41:748-759.
11 +
Mulliken JB, Grillo HC:  The limits of tracheal resection with primary anastomosis . J Thorac Cardiovasc Surg 1968;;55:418-421.
12 +
Sőm ML, Klein SH:  Primary anastomosis of the trachea after resection of a wide segment . J Mount Sinai Hosp 1958;;35:211-220.
13 +
Stalpaert G, Deneffe G, van Maele R:  Surgical treatment of adenoid cystic carcinoma of the left main bronchus and trachea by left pneumonectomy, resection of 7.5 cm of trachea, and direct reanastomosis of right lung . Thorax 1979;;34:554-556.
14 +
Cantrell JR, Folse JR:  The repair of circumferential defects of the trachea by direct anastomosis: Experimental evaluation . J Thorac Cardiovasc Surg 1961;;42:589-598.
15 +
Jackson TL, Lefkin P, Tuttle W, et al:  An experimental study in bronchial anastomosis . J Thorac Cardiovasc Surg 1949;;18:630-642.
16 +
Kiriluk LB, Merendino KA:  An experimental evaluation in the dog of bronchial transplantation, bronchial, tracheal and tracheobronchial resection with reconstruction . Ann Surg 1953;; 137:490-503.
17 +
Colley F:  Die Resektion der Trachea . Dtsch Z Chir 1895;;40:150-162.
18 +
Pacheco CR, Rivero O, Porter JK:  Experimental reconstructive surgery of the trachea . J Thorac Cardiovasc Surg 1954;;27:554-564.
19 +
McGregor IA: Fundamental Techniques of Plastic Surgery , ed 7. New York, Churchill Livingstone, 1980;.
20 +
Luft JH:  Improvements in epoxy resin embedding methods . J Biophys Biochem Cytol 1961;;9:409-414.
21 +
Anderson TF:  Techniques for the preservation of three-dimensional structure in preparing specimens for the electron microscope . Trans NY Acad Sci 1951;;13:130-134.
22 +
Grover FL, Ellestad C, Arom KV, et al:  Diagnosis and management of major tracheobronchial injuries . Ann Thorac Surg 1979;;28:384-391.
23 +
Pearson FG, Cooper JD, Nelems JM, et al:  Primary tracheal anastomosis after resection of the cricoid cartilage with preservation of recurrent laryngeal nerves . J Thorac Cardiovasc Surg 1975;;70:806-816.
24 +
Tsubota N, Simpson WJ, van Nostrand AW, et al:  The effects of preoperative irradiation of primary tracheal anastomosis . Ann Thorac Surg 1975;;20:152-160.
25 +
Ohlsén L, Nordin U:  Tracheal reconstruction with perichondrial grafts . Scand J Plast Reconstr Surg 1976;;10:135-145.
26 +
Nordin U:  The regeneration of cuff-induced tracheal injuries: An experimental study in rabbits . Acta Otolaryngol , to be published.

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