Akaki-Caballero M, Mar-Yáñez OG, Amador-Zapata IA

Language: Spanish
References: 12
Page: 158-168
PDF size: 500.59 Kb.

ABSTRACT

Objective: To find the differences between the slide tracheoplasty and tracheoplasty with resection and end-to-end anastomosis by measuring the gain in the postoperative circumference of the tracheal lumen, the resistance of the tracheal tissues by measuring the tension, the presence or absence of granuloma, and the histological changes by both procedures.
Material and method: An experimental, transversal and comparative study in which 10 leporidae (New Zealand white rabbits) were included, from which five underwent for slide tracheoplasty and the other five underwent for tracheoplasty with resection and end-to-end anastomosis for a total of 10 rabbits. The sacrifice was performed after seven days and then the larynx and trachea were removed for appropriate analysis, we make the report of the findings.
Results: The 10 rabbits survived the surgical procedure and the postoperative period without complications, finding an average gain of internal diameter of 2.1mm for slide tracheoplasty with a gain difference of 1.2 mm in slide tracheoplasty over the tracheoplasty with resection and end-to-end anastomosis (p=0.02), the difference in strength of tension found is 0.4 newton in favor of slide tracheoplasty (p=0.67). Neither surgical techniques presented intraluminal granuloma formation. Both techniques had postsurgical inflammation of mild to moderate. The end-to-end anastomosis had more submucosa granulation tissue formation.
Conclusion: Slide tracheoplasty presented the best results in gain of diameter, better vascularization leading to better healing, less strain and better mobilization of tissues without intraluminal granuloma formation.

REFERENCES

1. Koempel JA, Cotton RT. History of pediatric laryngotracheal reconstruction. Otolaryngologic Clinics of North America 2008;41:825-835.

2. Herrera P, Caldarone C, Forte V, et al. The current state of congenital tracheal stenosis. Pediatr Surg Int 2007;23:1033-1044.

3. Holinger PH, Kutnick SL, Schild JA, et al. Subglottic stenosis in infants and children. Ann Otol Rhinol Laryngol 1976;85:591-599.

4. Myer CM, O’Connor DM, CottonRT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994;103:319-323.

5. Triglia JM, Belus JF, Portaspana T, et al. Laryngeal stenosis in children. Evaluation of 10 years treatment. Ann Otolaryngol Chir Cervicofac 1995;112:279-284.

6. Stern Y, Gerber ME, Walner DL, et al. Partial cricotracheal resection with primary anastomosis in the pediatric age group. Ann Otol Rhinol Laryngol 1997;106:891-896

7. Acosta AC, Albanese CT, Farmer DL, et al. Tracheal stenosis: the long and the short of it., J Pediatr Surg 2000;35:1612-1616.

8. Tsang V, Murday A, Gillbe C, et al. Slide tracheoplasty for congenital funnel-shaped tracheal stenosis. Ann Thorac Surg 1989;48:632-635.

9. Yang JH, Jun TG, Sung K, et al. Repair of long-segment congenital tracheal stenosis. J Korean Med Sci 2007;22:491-496.

10. Grillo HC. Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg 1994;58:613-619.

11. Abdelkafy WM, El Atriby MN, Iskandar NM, Mattox DE, Mansour KA. Slide tracheoplasty applied to acquired subglottic and upper tracheal stenosis: an experimental study in a canine model. Arch Otolaryngol Head Neck Surg 2007;133:327-330.

12. Carneiro CG, Scapini F. The rabbit as an experimental model in laryngology. Int Arch Otorhinolaryngol 2009;13:146-150.