Document Detail


A new classification of bronchial anastomosis after sleeve lobectomy.
MedLine Citation:
PMID:  22841439     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Ischemia and infection of the distal part of the tracheobronchial anastomosis are the leading causes of bronchial anastomotic leakage with a high morbidity and mortality. To improve interpretation of healing of the anastomosis and the consequences, we have developed a classification scheme that allows quality control and defines early and standardized treatment of complications. PATIENTS AND METHOD: We conducted a retrospective analysis of the records of 202 patients treated in our institution between January 1, 2006 and December 31, 2010 after sleeve lobectomy. All patients received prophylactic inhalation with tobramycin 80 mg twice a day. Neoadjuvant treatment was given in 21% of the patients. Routine bronchoscopy on day 7 was performed with classification of the anastomosis as follows: X, unknown; 1, healing well with no fibrin deposits; 2, focal fibrin deposits and superficial (mucosal) necrosis; 3, circular fibrin deposits, superficial (mucosal) necrosis, and/or ischemia of the distal mucosa; 4, transmural necrosis with instability of the anastomosis; and 5, perforation, necrosis of the anastomosis, and insufficiency. RESULTS: The anastomosis was graded as satisfactory (1 and 2) in 86% of the patients. In 14%, it was regarded as critical (≥3-5) leading to systemic antibiotic treatment and control bronchoscopy. The overall 30-day mortality was 1%. CONCLUSIONS: Quality control of the tracheobronchial anastomosis comprised bronchoscopy performed before patients were dismissed. Inasmuch As postoperative bronchoscopy is not always performed by the operating surgeon, this classification is an aid to improve the description of endobronchial healing and to commence treatment of critical bronchial healing.
Authors:
Corinna Ludwig; Erich Stoelben
Related Documents :
15171309 - Modification of ultrasonographically measured endometrial thickness after discontinuati...
19455349 - Reproductive outcome following hysteroscopic adhesiolysis in patients with infertility ...
6418669 - Alveolitis sicca dolorosa after removal of impacted mandibular third molars.
264059 - Cribriform polypoid adenomatous (atypical) hyperplasia of the endocervical glands of th...
7286379 - Uterine cornual cauterization as a sterilization method.
1908799 - Subcutaneous injection or infusion of gonadotropin releasing-hormone agonist buserelin ...
24406579 - Patient-specific implants compared with stored bone grafts for patients with interval c...
16516739 - Stabilization of the proximal ulnar stump in the sauvé-kapandji procedure by using the...
11912379 - Contemporary morbidity from lymphadenectomy for penile squamous cell carcinoma: the m.d...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-26
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  -     ISSN:  1097-685X     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Thoracic Surgery, Lungenklinik Merheim, Kliniken der Stadt Köln gGmbH, Cologne, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Four-dimensional, flow-sensitive magnetic resonance imaging of blood flow patterns in thoracic aorti...
Next Document:  Bezafibrate can be a new treatment option for mitochondrial fatty acid oxidation disorders: Evaluati...