Endoscopic Tracheoplasty Segmental Tracheal Ring Resection in a Porcine Model

被引:1
|
作者
Schwartz, Gary S. [1 ]
Razi, Syed Shahzad [1 ]
Belsley, Scott J. [1 ]
Boone, Deva [1 ]
Latif, Mohammed J. [1 ]
Connery, Cliff P. [1 ]
Lebovics, Robert S. [2 ]
Bhora, Faiz Y. [1 ]
机构
[1] Columbia Univ Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Dept Surg, Div Thorac Surg, New York, NY 10032 USA
[2] Columbia Univ Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Dept Otolaryngol, New York, NY 10032 USA
关键词
benign tracheal stenosis; endoscopy; tracheoplasty; Wegener granulomatosis;
D O I
10.1097/LBR.0b013e3181ea9a9b
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Endoscopic tracheoplasty is used for the relief of airway obstruction because of several benign conditions such as postintubation stenosis, inflammatory disorders such as Wegener granulomatosis, and benign neoplastic processes. Several endoscopic treatment modalities exist for these conditions, all with good initial results. However, recurrence is common and often requires frequent reintervention. Endoscopic segmental tracheal ring resection is a novel therapeutic approach that could potentially provide a durable solution. Endoscopic segmental tracheal ring resection was performed in 3 Yorkshire pigs under general anesthesia. A combination of bipolar cautery and sharp dissection was used to resect 25% to 33% of the circumference of a single tracheal ring. Technical success was achieved in all 3 animals with no intraoperative complications. Full-thickness excision, including the anterior perichondrium, was performed in 1 animal without violation of the pretracheal fascia, with no subcutaneous emphysema or clinically apparent pneumothorax. Average operative time was 31 minutes and estimated blood loss was minimal. Heart rate, oxygen saturation, and peak airway pressures were maintained within normal ranges during the procedure and for the 60-minute postoperative period. Histologic analysis of the resected specimen confirmed complete thickness excision of the segment of tracheal cartilage. Endoscopic tracheoplasty by segmental tracheal ring resection is a safe and feasible technique in a porcine model. Long-term durability could potentially outlast other endoscopic techniques for the treatment of bening tracheal stenosis. Survival studies in a porcine model of tracheal stenosis must be performed to assess the long-term outcomes of this approach.
引用
收藏
页码:232 / 235
页数:4
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