Does successful segmental tracheal resection require releasing maneuvers?

Abstract

Objectives: To review a series of patients undergoing primary tracheal resection and anastomosis for tracheal stenosis without additional releasing maneuvers. Methods: Retrospective chart review. All patients undergoing segmental tracheal resection by the first author over a 5-year period had their charts reviewed. Results: Fifteen patients were identified over a 5-year period. There were 7 men and 8 women from ages 29–76. Preoperatively, the airways abnormalities were characterized as follows: 3 patients with moderate (51%-70%) airway compromise, 9 patients with severe (71%-90%) compromise, and 4 patients complete or near complete airway obstruction (>90%). Five of the 15 had a tracheotomy at the time of the open procedure. All patients were managed with segmental tracheal resection and anastomosis without stenting or postoperative tracheotomy. No releasing maneuvers were performed. 14/15 (93%) patients had successful treatment of their stenosis. One patient with a mild stenosis (grade II) failed and required tracheotomy following a Staphylococcus aureus wound infection. Only 1 patient required bronchoscopic dilation of an anastomotic stricture (1/15, 7%). Follow-up was from 3 months to 5 years, with a median of 27 months. Conclusions: In this series of selected patients, segmental airway resection for tracheal stenosis was successfully accomplished without additional “releasing” techniques.