Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1973 Nov;28(6):667–679. doi: 10.1136/thx.28.6.667

Reconstruction of the trachea

Experience in 100 consecutive cases 1

Hermes C Grillo 1
PMCID: PMC470101  PMID: 4362789

Abstract

Grillo, H. C. (1973).Thorax, 28, 667-679. Reconstruction of the trachea. Experience in 100 consecutive cases. Anatomic mobilization of the trachea permits resection of one-half or more with primary anastomosis. An anterior approach by a cervical or cervicomediastinal route utilizes cervical flexion to devolve the larynx and tracheal mobilization with preservation of the lateral blood supply. The transthoracic route is employed for lower tracheal lesions.

Over 100 tracheal resections have been done using these methods of direct reconstruction. Eighty-four patients suffered from benign strictures, 79 resulting from intubation injuries. Eleven primary tracheal tumours and five secondary tumours are included. The majority of lesions following intubation occurred at the level of the cuff. It was possible to repair 78 of the 84 stenotic lesions through a cervical or cervicomediastinal approach. Seventy-three of the 84 patients with inflammatory lesions obtained an excellent or good functional and anatomic result. Nine of 11 patients with primary neoplasms who underwent reconstruction are alive and without known disease. There were five early postoperative deaths in these 100 consecutive patients who underwent tracheal reconstruction.

Full text

PDF
667

Images in this article

668Image
on p.668
669Image
on p.669
670Image
on p.670
670Image
on p.670
671Image
on p.671
672Image
on p.672
673Image
on p.673
673Image
on p.673
675Image
on p.675
675Image
on p.675
676Image
on p.676

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrews M. J., Pearson F. G. Incidence and pathogenesis of tracheal injury following cuffed tube tracheostomy with assisted ventilation: analysis of a two-year prospective study. Ann Surg. 1971 Feb;173(2):249–263. doi: 10.1097/00000658-197102000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BARCLAY R. S., McSWAN N., WELSH T. M. Tracheal reconstruction without the use of grafts. Thorax. 1957 Sep;12(3):177–180. doi: 10.1136/thx.12.3.177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BELSEY R. Resection and reconstruction of the intrathoracic trachea. Br J Surg. 1950 Oct;38(150):200–205. doi: 10.1002/bjs.18003815008. [DOI] [PubMed] [Google Scholar]
  4. CANTRELL J. R., FOLSE J. R. The repair of circumferential defects of the trachea by direct anastomosis: experimental evaluation. J Thorac Cardiovasc Surg. 1961 Nov;42:589–598. [PubMed] [Google Scholar]
  5. Cooper J. D., Grillo H. C. The evolution of tracheal injury due to ventilatory assistance through cuffed tubes: a pathologic study. Ann Surg. 1969 Mar;169(3):334–348. doi: 10.1097/00000658-196903000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dedo H. H., Fishman N. H. Laryngeal release and sleeve resection for tracheal stenosis. Ann Otol Rhinol Laryngol. 1969 Apr;78(2):285–296. doi: 10.1177/000348946907800208. [DOI] [PubMed] [Google Scholar]
  7. Florange W., Muller J., Forster E. Morphologie de la nécrose trachéale après trachéotomie et utilisation d'une prothèse respiratoire. Anesth Analg (Paris) 1965 Oct-Dec;22(4):693–703. [PubMed] [Google Scholar]
  8. GRILLO H. C., BENDIXEN H. H., GEPHART T. RESECTION OF THE CARINA AND LOWER TRACHEA. Ann Surg. 1963 Nov;158:889–893. doi: 10.1097/00000658-196311000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. GRILLO H. C., DIGNAN E. F., MIURA T. EXTENSIVE RESECTION AND RECONSTRUCTION OF MEDIASTINAL TRACHEA WITHOUT PROSTHESIS OR GRAFT: AN ANATOMICAL STUDY IN MAN. J Thorac Cardiovasc Surg. 1964 Nov;48:741–749. [PubMed] [Google Scholar]
  10. Geffin B., Bland J., Grillo H. C. Anesthetic management of tracheal resection and reconstruction. Anesth Analg. 1969 Sep-Oct;48(5):884–890. [PubMed] [Google Scholar]
  11. Geffin B., Grillo H. C., Cooper J. D., Pontoppidan H. Stenosis following tracheostomy for respiratory care. JAMA. 1971 Jun 21;216(12):1984–1988. [PubMed] [Google Scholar]
  12. Grillo H. C. Circumferential resection and reconstruction of the mediastinal and cervical trachea. Ann Surg. 1965 Sep;162(3):374–388. doi: 10.1097/00000658-196509000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Grillo H. C., Cooper J. D., Geffin B., Pontoppidan H. A low-pressure cuff for tracheostomy tubes to minimize tracheal injury. A comparative clinical trial. J Thorac Cardiovasc Surg. 1971 Dec;62(6):898–907. [PubMed] [Google Scholar]
  14. Hajdu S. I., Huvos A. G., Goodner J. T., Foote F. W., Jr, Beattie E. J., Jr Carcinoma of the trachea. Clinicopathologic study of 41 cases. Cancer. 1970 Jun;25(6):1448–1456. doi: 10.1002/1097-0142(197006)25:6<1448::aid-cncr2820250625>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  15. Harley H. R. Laryngotracheal obstruction complicating tracheostomy or endotracheal intubation with assisted respiration. A critical review. Thorax. 1971 Sep;26(5):493–533. doi: 10.1136/thx.26.5.493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Houston H. E., Payne W. S., Harrison E. G., Jr, Olsen A. M. Primary cancers of the trachea. Arch Surg. 1969 Aug;99(2):132–140. doi: 10.1001/archsurg.1969.01340140004002. [DOI] [PubMed] [Google Scholar]
  17. Macmillan A. S., James A. E., Jr, Stitik F. P., Grillo H. C. Radiological evaluation of post-tracheostomy lesions. Thorax. 1971 Nov;26(6):696–703. doi: 10.1136/thx.26.6.696. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Mulliken J. B., Grillo H. C. The limits of tracheal resection with primary anastomosis: further anatomical studies in man. J Thorac Cardiovasc Surg. 1968 Mar;55(3):418–421. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES