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J Thorac Cardiovasc Surg 1999;117:1112-1117
© 1999 Mosby, Inc.

GENERAL THORACIC SURGERY

TRACHEOBRONCHIAL SLEEVE RESECTION WITH THE USE OF A CONTINUOUS ANASTOMOSIS: RESULTS OF ONE HUNDRED CONSECUTIVE CASES

From the Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom.

Received for publication Dec 7, 1998. Revisions requested Jan 8, 1999. Revisions received Feb 12, 1999. Accepted for publication Feb 19, 1999. Address for reprints: Cemal Asim Kutlu, MD, Nispetiye Cad, Saydam Sok, 20/1, Levent 80600, Istanbul, Turkey.

Objective: We have used a continuous suture technique for all tracheal and bronchial anastomoses with satisfactory results in our institution. The objective of this article is to review our experience with sleeve resections using this technique and report the associated morbidity and mortality in 100 consecutive cases.
Methods: Our experience with sleeve resection using a continuous suture (3-0 polypropylene) technique was reviewed in 100 consecutive cases. The median age of the patients was 53.3 years with a range of 21 to 81 years. There were 54 male patients and 46 female patients. Resection was undertaken for malignant disease in 81 patients, acquired stricture in 14 patients, benign tumor in 4 patients, and trauma in 1 patient. Among 28 patients in whom lung parenchyma was not resected, 16 patients had tracheal resection and 12 had bronchial sleeve resection. Sleeve pneumonectomy was undertaken in 2, sleeve lobectomy in 66, and sleeve segmentectomy in 4.
Results: There were 12 postoperative complications (12%) and 2 postoperative deaths resulting from bronchoatrial fistula and pneumonia (2%). Stricture as a late complication occurred in 5 patients, 2 of whom required a bronchial stent. Other late complications were bougienage, reanastomosis, and completion pneumonectomy (1 each).
Conclusion: Our experience suggests that the results of continuous suture technique are comparable with those from reported series using interrupted suture technique for tracheal and bronchial anastomosis.

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