Database : MEDLINE
Search on : Tracheal and Stenosis [Words]
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[PMID]: 29518535
[Au] Autor:Kumar TKS; Immanuel C; Thompson J; Shah S; Knott-Craig C
[Ad] Address:Department of Pediatric Cardiothoracic Surgery. Electronic address: tskumar@uthsc.edu.
[Ti] Title:Successful Use of Aortic Homograft for Residual Tracheal Stenosis Following Slide Tracheoplasty.
[So] Source:Semin Thorac Cardiovasc Surg;, 2018 Mar 05.
[Is] ISSN:1532-9488
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher

  2 / 7150 MEDLINE  
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[PMID]: 29351592
[Au] Autor:Mohsen T; Abou Zeid A; Abdelfattah I; Mosleh M; Adel W; Helal A
[Ad] Address:Department of Cardiothoracic Surgery, Kasr Alainy Hospital, Cairo University, Cairo, Egypt.
[Ti] Title:Outcome after long-segment tracheal resection: study of 52 cases.
[So] Source:Eur J Cardiothorac Surg;, 2018 Jan 16.
[Is] ISSN:1873-734X
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Resection of long-segment trachea is challenging, and although 50% of adult trachea can be removed, anastomotic complications arise proportionally. Different release manoeuvres have been described to gain length and reduce tension at the suture line. The aim of the study was to evaluate the outcome when different release manoeuvres have been utilized during resection and reconstruction of the trachea. METHODS: From January 2005 to December 2015, 52 patients with long segments of trachea ≥40 mm requiring resection and reconstruction were treated at our institute. Demographic, operative and postoperative data were retrospectively analysed. RESULTS: Fifty-two patients with long-segment tracheal disorders ≥40 mm were analysed in this stud. Transient swallowing and phonation dysfunction occurred in 17 (32.2%) patients, exclusively in patients who underwent laryngeal release. Swallowing dysfunction was Grade I in all patients, except 2 who suffered Grade II dysphagia and were relieved in the early postoperative period. Forty-five (86.5%) patients were symptom free, and 7 (13.4%) patients were symptomatic (dyspnoea on exertion and/or stridor) and required reintervention. Four (7.6%) patients responded to 1 or 2 sessions of bronchoscopic dilatation, and 3 patients were left with permanent tracheostomies. Patients with neoplastic pathology were followed up without any neoplastic recurrence. CONCLUSIONS: Long-segment resection and reconstruction of the trachea utilizing one or more release manoeuvres can be safely done, with low complication rates. Although swallowing and phonation dysfunction after laryngeal release were commonly encountered (almost one-third of patients), they were mild, transient, self-limited and recovered within 2-3 weeks of the early postoperative period.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/ejcts/ezx475

  3 / 7150 MEDLINE  
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[PMID]: 29346567
[Au] Autor:Den Hondt M; Vanaudenaerde BM; Verbeken EK; Vranckx JJ
[Ad] Address:Department of Plastic and Reconstructive Surgery, University Hospitals Leuven, Leuven, Belgium.
[Ti] Title:Epithelial grafting of a decellularized whole-tracheal segment: an in vivo experimental model.
[So] Source:Interact Cardiovasc Thorac Surg;, 2018 Jan 15.
[Is] ISSN:1569-9285
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Prerequisites for successful trachea transplantation include the use of a biocompatible construct, submucosal vascularization and an epithelial covering. Implantation of non-epithelialized tracheal scaffolds may lead to stenosis. However, epithelial grafting or seeding can only be attempted onto a well-vascularized submucosal bed. Our aim was to investigate a method to prevent stenosis during prelamination of non-epithelialized, gently decellularized rabbit tracheae and to evaluate whether grafting of revascularized constructs with buccal mucosa is feasible. METHODS: Allotracheae underwent two 48-h cycles of detergent-enzymatic decellularization using sodium deoxycholate and DNAse. In the first series, 12 circular scaffolds were implanted bilaterally in lateral thoracic artery flaps (n = 6 rabbits). Right-sided transplants were covered internally with Integra™. In the second series, 10 decellularized tracheae covered with Integra were prelaminated in flaps (n = 10 rabbits). Twenty-one days after implantation, revascularized tracheae were grafted with buccal mucosa. A macroscopic, histological analysis and immunohistochemistry were performed on explants. RESULTS: In the first series, tracheae without Integra covering developed significantly greater intraluminal (P = 0.032) and subepithelial narrowing (P = 0.0345) compared with tracheae with Integra covering. All tracheae exhibited insufficient submucosal revascularization. In the second series, submucosal revascularization was incomplete in the first 2 constructs, which were implanted circularly. These tracheae only showed marginal buccal graft ingrowth. To accelerate revascularization, the subsequent 8 transplants were opened longitudinally before implantation. Compared to circularly implanted tracheae, submucosal revascularization of these transplants was superior (P = 0.0008). Graft adherence was complete in 6 opened constructs. Mild lymphocytic infiltration within the buccal graft was detected in 5 specimens. CONCLUSIONS: We observed satisfactory host integration of opened tracheae that were temporarily covered with Integra during revascularization and subsequently grafted with buccal mucosa. Integra successfully prevented stenosis during revascularization. This model may provide an example of an immunosuppressive-free approach in the treatment of long-segment tracheal lesions. With the aid of further refinements such as a respiratory epithelial lining, an orthotopically transplantable construct could be created.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/icvts/ivx442

  4 / 7150 MEDLINE  
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[PMID]: 29244167
[Au] Autor:Arcieri L; Pak V; Poli V; Baggi R; Serio P; Assanta N; Moschetti R; Noccioli B; De Masi S; Mirabile L; Murzi B
[Ad] Address:Pediatric Cardiac Surgery Unit, Heart Hospital, G. Monasterio Foundation, Massa, Italy.
[Ti] Title:Tracheal surgery in children: outcome of a 12-year survey.
[So] Source:Interact Cardiovasc Thorac Surg;, 2017 Dec 12.
[Is] ISSN:1569-9285
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Despite the fact that team management has improved the results in recent years, perioperative deaths and complications remain high in paediatric tracheal surgery. We reviewed our institutional experience by comparing our results with those in the literature. METHODS: Between 2005 and 2017, 30 children underwent surgery for tracheal disease. Fifteen were boys and fifteen were girls (50% vs 50%). The median age at operation was 7 months (15 days-9.6 years), and the median weight was 5.2 kg (2.8-34 kg). Congenital tracheal stenosis was diagnosed in 25 children (83.3%), and 5 (16.7%) had acquired lesions. The mean internal diameter in congenital tracheal stenosis was 1.5 mm, with complete tracheal rings present in all patients. Associated malformations were bronchopulmonary in 11 cases (36.7%) and cardiovascular in 16 (53.3%). RESULTS: No in-hospital deaths occurred in our data set. Overall mortality was 4 of 30 cases (13.3%). Twenty-four endoscopic reinterventions were required in 19 children (63%) and consisted of stent positioning in 13 (43.3%), balloon dilatation in 5 (16.7%), granulation removal in 4 (13.3%) and tracheostomy in 2 (6.7%). Of the survivors (26 of 30, 86.7%), 11 children (42.3%) did not require further examination on adequate tracheal diameter for age and absence of symptoms after a median follow-up period of 3.5 years. CONCLUSIONS: The result of paediatric tracheal surgery depends on several factors. The number of cases treated at a particular centre is an important one, but our experience, although limited, can be compared with that at centres with a higher volume of cases. We emphasize the need for applying a multidisciplinary approach to master the surgical command of different reconstructive tracheal procedures, to manage associated defects, particularly cardiovascular defects, and to manage complications under endoscopic guidance. These can be considered the mainstays of building a successful tracheal programme.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/icvts/ivx390

  5 / 7150 MEDLINE  
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[PMID]: 29513385
[Au] Autor:Naunheim MR; Paddle PM; Husain I; Wangchalabovorn P; Rosario D; Franco RA
[Ad] Address:Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
[Ti] Title:Quality-of-Life Metrics Correlate With Disease Severity in Idiopathic Subglottic Stenosis.
[So] Source:Laryngoscope;, 2018 Mar 07.
[Is] ISSN:1531-4995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Idiopathic subglottic stenosis (ISGS) can have significant impacts on quality of life (QOL), but it remains unclear how patients' subjective responses correlate with objective measurement of disease severity. Peak expiratory flow percentage (PEF%) has been shown to be an effective measure of disease severity in subglottic stenosis. This study aims to identify the key QOL questions correlated with PEF% and proposes a statistical model for prediction of disease severity. METHODS: Patients with ISGS presenting to an academic laryngologist were included retrospectively from 2012 to 2016. Peak expiratory flow percentage (age, sex, and height adjusted) was recorded for each visit, along with four validated QOL instruments (European QOL-Five Dimensions; RAND 36-Item Health Survey; Clinical COPD [Chronic Obstructive Pulmonary Disease] Questionnaire; and the Airway, Dyspnea, Voice, and Swallowing Summary Assessment). A stepwise multiple linear regression was used to identify statistically significant independent variables correlated with PEF%, and a model was built with these variables. RESULTS: Thirty-two patients were included, with a total of 271 patient encounters. Overall scores from each of the four QOL instruments were correlated with PEF% values recorded each visit (P < 0.05). Question responses correlating most positively included overall breathlessness, difficulty catching breath, cough within the past week, dyspnea with moderate activity, perception that voice changes are restricting social life, and overall general health (all P < 0.01). A model constructed using six nonoverlapping questions yielded an adjusted R of 0.58. CONCLUSION: Quality of life is correlated to PEF% in ISGS. Using a limited number of QOL questions, clinicians can predict objective worsening or improvement of disease severity, as measured by spirometry. LEVEL OF EVIDENCE: 2b. Laryngoscope, 2017.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1002/lary.26930

  6 / 7150 MEDLINE  
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[PMID]: 29509540
[Au] Autor:Sabau AD; Hassan N; Smarandache CG; Mihetiu A; Tîtu Ș; Sabau D
[Ti] Title:Laparogastroscopy and Esophageal Stenosis.
[So] Source:Chirurgia (Bucur);113(1):137-143, 2018 Jan-Feb.
[Is] ISSN:1221-9118
[Cp] Country of publication:Romania
[La] Language:eng
[Ab] Abstract:PURPOSE: An original technique using laparoscopic instruments in a gastric endocavitary work chamber with potential for esophagus, stomach and D1 vizualisation. The main purpose of laparagastroscopy is to improve the quality of life of the patient disabling by the esophageal tumor. This method has several advantages: providing physiological feeding, harvesting materials for histopathological examination, solving eso-tracheal fistulas concurrently with the proposed operation and hemostatic role through compression, low energy and plastic consumption, rapid socio-economic reintegration, mental psychological care of the patient. Patients and The paper deals with 162 cases with different tumors of the esophagus, patients with different grades of esophageal stenosis, different stages of esophageal neoplasm. Both the patients with eso-tracheal fistulas and those with gastro- or jejunostoma were included. From 162 cases, 33 cases (20%) with cervical esophageal neoplasm, 66 (41%) cases with thoracic esophageal neoplasm and 63 (39%) cases with abdominal esophageal neoplasm. The histopathological type is 37% adenocarcinomas and 63% squamous carcinomas. From total number of cases, 87 (54%) had no metastasis, and 75 (46%) had secondary determinations. The most frequent localization of metastasis was pulmonary, followed by liver (Fig. 1) and bone. The analysis of this intervention has shown that complications have been much lower both in terms of their numerical value and their severity, a longer survival time with a much higher satisfaction index is ensured. CONCLUSION: Esophageal endoprosthesis (EPE) through laparagastroscopic approach should be a a reserve procedure instead of a disabling gastrostomy or jejunostomy. EPE is an extremely effective procedure specially by keeping the physiology of food bowl. The approach is minimally invasive with minimal attack on the body with significant plastic and aesthetic reductions. This procedure allows the prosthesis to be viewed both during and after stenting to check its correct position. This method increases the survival time by keeping a relatively normal regimen.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review

  7 / 7150 MEDLINE  
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[PMID]: 29428562
[Au] Autor:Gerhardt B; Leesman L; Burra K; Snowball J; Rosenzweig R; Guzman N; Ambalavanan M; Sinner D
[Ad] Address:Division of Neonatology and Pulmonary Biology, CCHMC, University of Cincinnati, College of Medicine and University Honors Program, Cincinnati, OH 45229, United States of America.
[Ti] Title:Notum attenuates Wnt/ß-catenin signaling to promote tracheal cartilage patterning.
[So] Source:Dev Biol;, 2018 Feb 09.
[Is] ISSN:1095-564X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Tracheobronchomalacia (TBM) is a common congenital disorder in which the cartilaginous rings of the trachea are weakened or missing. Despite the high prevalence and clinical issues associated with TBM, the etiology is largely unknown. Our previous studies demonstrated that Wntless (Wls) and its associated Wnt pathways are critical for patterning of the upper airways. Deletion of Wls in respiratory endoderm caused TBM and ectopic trachealis muscle. To understand mechanisms by which Wls mediates tracheal patterning, we performed RNA sequencing in prechondrogenic tracheal tissue of Wls ;Shh embryos. Chondrogenic Bmp4, and Sox9 were decreased, while expression of myogenic genes was increased. We identified Notum, a deacylase that inactivates Wnt ligands, as a target of Wls induced Wnt signaling. Notum's mesenchymal ventral expression in prechondrogenic trachea overlaps with expression of Axin2, a Wnt/ß-catenin target and inhibitor. Notum is induced by Wnt/ß-catenin in developing trachea. Deletion of Notum activated mesenchymal Wnt/ß-catenin and caused tracheal mispatterning of trachealis muscle and cartilage as well as tracheal stenosis. Notum is required for tracheal morphogenesis, influencing mesenchymal condensations critical for patterning of tracheal cartilage and muscle. We propose that Notum influences mesenchymal cell differentiation by generating a barrier for Wnt ligands produced and secreted by airway epithelial cells to attenuate Wnt signaling.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher

  8 / 7150 MEDLINE  
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[PMID]: 29497994
[Au] Autor:Malpas G; Hung O; Gilchrist A; Wong C; Kent B; Hirsch GM; Hart RD
[Ad] Address:Department of Anesthesia, Pain Management and Perioperative Medicine, Queen Elizabeth II Health Sciences, Dalhousie University, 1278 South Park St, Halifax, NS, B3H 2Y9, Canada. gmalpas@icloud.com.
[Ti] Title:Recours à l'oxygénation extracorporelle en prévision de la gestion de voies respiratoires difficiles : rapport de cas et étude systématique. The use of extracorporeal membrane oxygenation in the anticipated difficult airway: a case report and systematic review.
[So] Source:Can J Anaesth;, 2018 Mar 01.
[Is] ISSN:1496-8975
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:While extracorporeal membrane oxygenation (ECMO) is an effective method of oxygenation for patients with respiratory failure, further refinement of its incorporation into airway guidelines is needed. We present a case of severe glottic stenosis from advanced thyroid carcinoma in which gas exchange was facilitated by veno-arterial ECMO prior to achieving a definitive airway. We also conducted a systematic review of the MEDLINE, EMBASE, CINAHL, and Web of Science databases, using the keywords "airway/ tracheal obstruction", "anesthesia", "extracorporeal", and "cardiopulmonary bypass" to identify reports where ECMO was initiated as the a priori method of oxygenation during difficult airway management.Thirty-six papers were retrieved discussing the use of ECMO or cardiopulmonary bypass (CPB) for the management of critical airway obstruction. Forty-five patients underwent pre-induction of anesthesia institution of CPB or ECMO for airway obstruction. The patients presenting with critical airway obstruction had a range of airway pathologies with tracheal tumours (31%), tracheal stenosis (20%), and head and neck cancers (20%) being the most common. All cases reported a favourable patient outcome with all patients surviving to hospital discharge without significant complications.While most practitioners are familiar with the fundamental airway techniques of bag-mask ventilation, supraglottic airway use, tracheal intubation, and front-of-neck airway access for oxygenation, these techniques have limitations in managing patients with pre-existing severe airway obstruction. The use of ECMO should be considered in patients with severe (or near-complete) airway obstruction secondary to anterior neck or tracheal disease. This approach can provide essential tissue oxygenation while attempts to secure a definitive airway are carried out in a controlled environment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[St] Status:Publisher
[do] DOI:10.1007/s12630-018-1099-x

  9 / 7150 MEDLINE  
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[PMID]: 29489542
[Au] Autor:Thomet C; Modarressi A; Rüegg EM; Dulguerov P; Pittet-Cuénod B
[Ti] Title:Long-Segment Tracheal Reconstruction With Free Radial Forearm Flap Reinforced by Rib Cartilage.
[So] Source:Ann Plast Surg;, 2018 Feb 27.
[Is] ISSN:1536-3708
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Long-segment tracheal reconstruction remains a challenge. The ideal tracheal substitute should be an epithelialized tube to prevent stenosis and sufficiently rigid to maintain airflow patency. An autologous technique using a radial forearm free flap reinforced by rib cartilage has been recently described for tracheal reconstruction. We report here two cases of complex tracheal reconstruction with a modification of this technique, which consists of the creation of two independent skin paddles to allow the reconstruction of the trachea and a second adjacent defect (eg, cervical skin, esophagus). Airway patency was achieved with no stenosis, prolonged stenting, fistula, or necrosis after 26 and 44 months, respectively. We suggest that the satisfactory outcome obtained with this modified technique is a valuable option for tracheal and adjacent defect reconstruction without the need for a second flap.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:Publisher
[do] DOI:10.1097/SAP.0000000000001399

  10 / 7150 MEDLINE  
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[PMID]: 29448837
[Au] Autor:Jing H; Gao B; Gao M; Yin H; Mo X; Zhang X; Luo K; Feng B; Fu W; Wang J; Zhang W; Yin M; Zhu Z; He X; Zheng J
[Ad] Address:a Department of Cardiothoracic Surgery , Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine , Shanghai , China.
[Ti] Title:Restoring tracheal defects in a rabbit model with tissue engineered patches based on TGF-ß3-encapsulating electrospun poly(l-lactic acid-co-ε-caprolactone)/collagen scaffolds.
[So] Source:Artif Cells Nanomed Biotechnol;:1-11, 2018 Feb 15.
[Is] ISSN:2169-141X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Long segment tracheal stenosis often has a poor prognosis due to the limited availability of materials for tracheal reconstruction. Tissue engineered tracheal patches based on electrospun scaffolds and stem cells present ideal solutions to this medical challenge. However, the established engineering process is inefficient and time-consuming. In our research, to optimize the engineering process, core-shell nanofilms encapsulating TGF-ß3 were fabricated as scaffolds for tracheal patches. The morphological and mechanical characteristics, degradation and biocompatibility of poly(l-lactic acid-co-ε-caprolactone)/collagen (PLCL/collagen) scaffolds with different compositions (PLCL:collagen 75:25, 50:50 and 25:75, respectively) were comparatively evaluated to determine the preferable compositional ratio. Then the chondrogenesis-inducing potential is investigated, and tracheal patches based on electrospun scaffolds and bone marrow mesenchymal stem cells (BMSCs) were constructed to restore tracheal defects in rabbit models. The results indicated that core-shell scaffolds with a PLCL/collagen proportion of 75:25 were eligible for tracheal patches. The stable and sustained release of TGF-ß3 from scaffolds could efficiently promote the chondrogenic differentiation of BMSCs and shorten the incubation time. Tracheal integrity was well maintained for 2 months after restoration; meanwhile, re-epithelialization also achieved. In conclusion, TGF-ß3-encapsulating core-shell electrospun scaffolds with a PLCL/collagen proportion of 75:25 could be used to optimize engineering process of tracheal patches.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:Publisher
[do] DOI:10.1080/21691401.2018.1439844


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