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J Thorac Cardiovasc Surg 1997;114:934-939
© 1997 Mosby, Inc.

GENERAL THORACIC SURGERY

REOPERATIVE TRACHEAL RESECTION AND RECONSTRUCTION FOR UNSUCCESSFUL REPAIR OF POSTINTUBATION STENOSIS

Received for publication May 5, 1997 Revisions requested June 2, 1997 Revisions received July 7, 1997 Accepted for publication August 8, 1997 Address for reprints: Hermes C. Grillo, MD, Thoracic Surgical Unit, Blake 1570, Massachusetts General Hospital, Boston, MA 02114.

Abstract

Objective: Our objective was to analyze characteristics and results of redo tracheal resection and reconstruction. Methods: Seventy-five patients were operated on between 1966 and 1997 after unsuccessful initial repairs for postintubation tracheal stenosis. Results: Sixteen of these patients came from a group of 32 patients with unsuccessful repair among the 450 primary resections and reconstructions performed at our institution. Fifty-nine patients were referred to us after unsuccessful initial repair elsewhere. Initial management was a T-tube or tracheotomy in 39 patients. The length of repeat resection ranged from 1.0 cm to 5.5 cm (mean 3.5 cm). A laryngeal release was used in 19 patients (25%) to reduce anastomotic tension. Complications occurred in 29 patients (39%) and were most frequent in the group requiring laryngeal release (12/19, 63.2%). Overall outcome was good in 59 patients (78.6%) and satisfactory in 10 (13.3%). The repair was unsuccessful in four patients (5.3%), and two patients died (2.6%). Conclusions: Despite difficulties encountered in reoperative surgery after failed tracheal reconstruction for postintubation stenosis, successful outcome may be achieved in a large number of cases.

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