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Review
. 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

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Free PMC article
Review

Treatment of Large Tracheal Defects After Resection: Laryngotracheal Release and Tracheal Replacement

Andreas Kirschbaum et al. Auris Nasus Larynx. .
Free PMC article

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.

Conflict of interest statement

All authors declares no conflict of interest

Figures

Figure 1
Figure 1
The principle of suprahyoid release with cutting of the hyoid bone and mobilization of the trachea in a caudal direction (↓)
Figure 2
Figure 2
Mobilization of the distal trachea (→) and both main bronchi using video assisted mediastinoscopy
Figure 3
Figure 3
Mobilization (→) of the right hilar vessels in a cranial direction by cutting the pericardium (right hilar release)

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