The effect of suture techniques on the outcome of tracheal reconstruction: An observational study and review of literature

Ziaian, Bizhan; Shahriarirad, Reza; Fouladi, Damoun; Amirian, Armin; Ranjbar, Keivan; Karoobi, Mohammadreza; Ketabchi, Farzaneh; Mardani, Parviz; Fallahi, Mohammad Javad

doi:10.1016/j.surge.2022.03.008

Cited by 7 publications

(4 citation statements)

References 48 publications

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“…However, primary surgical repair may not always be effective especially if signs of advanced mediastinitis or infection were observed, in which case discontinuity resections are a better choice for further surgery [26]. Our previous report has demonstrated the higher efficacy of continuous sutures in reconstructive surgery [27]. More aggressive surgical methods including esophageal resection, diversion, exclusion, or T-tube insertion could be considered for patients with severe esophageal injury and simultaneous infection [28].…”

Section: Discussionmentioning

confidence: 99%

Esophageal perforation etiology, outcome, and the role of surgical management – an 18-year experience of surgical cases in a referral center

et al. 2023

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Introduction Esophageal perforation is a surgical emergency with a high rate of morbidity and mortality. Its poor prognosis is mainly associated with previous patient-specific comorbidities and a lack of timely diagnosis and treatment. The objective of this study was to investigate the etiological factors and different surgical methods of treatment with consideration of mortality rate and comorbidities. Method The present cross-sectional study was conducted on patients who underwent surgical intervention due to esophageal injury from 2002 to 2019 (18 years). Demographic and clinical characteristics along with performed surgical interventions were evaluated accordingly. Results In this study, 69 patients with a mean age of 38.8 years were evaluated, of which 45 (65.2%) cases were men. In terms of location of the perforation, the thoracic portion of the esophagus followed by the cervical and abdominal esophagus were more frequently injured with a rate of 32 (46.4%), 30 (43.5%), and 19 (27.5%) cases, respectively. Accordingly, foreign body ingestion followed by penetrating injuries were the most common causative agents leading to esophageal perforation. Conclusion Obtaining the desired results from the treatment of this condition depends on factors such as patients’ previous comorbidities, cause of the rupture, the location of the esophageal damage, and delay in the start of treatment. Since there is no single gold standard treatment strategy, each patient should be individually evaluated.

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Section: Discussionmentioning

confidence: 99%

Esophageal perforation etiology, outcome, and the role of surgical management – an 18-year experience of surgical cases in a referral center

et al. 2023

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“…Future studies with larger sample sizes to compare these two surgical techniques are recommended. Also, detailed evaluation of the equipment used can affect the outcome, such as the type of suture and technique 32 . Moreover, future clinical trials, including the stapled technique in addition to the hand‐sewn technique, are suggested.…”

Section: Discussionmentioning

confidence: 99%

Hand‐sewn direct repair versus resection and hand‐sewn anastomosis techniques for the reversal of diverting loop ileostomy after lower anterior rectal resection surgery: A randomized clinical trial

Keramati

Yazd

Shahriarirad

et al. 2022

Journal of Surgical Oncology

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Introduction Several techniques have been proposed for the closure of loop ileostomy. This is the first study comparing bowel function and outcomes of two different hand‐sewn surgical techniques used for the closure of diverting protective loop ileostomy. Method In this prospective, randomized, double‐blind clinical trial, 40 patients with a history of rectal cancer, low anterior resection, and diverting loop ileostomy who were candidates for ileostomy reversal were included and randomly assigned into two groups, hand‐sewn direct repair of the ileal defect (group A) and resection and hand‐sewn anastomosis of the ileum (group B). Results The mean age of patients was 56.42 and 52.10 years in groups A and B, respectively. Regarding early postoperative period, group A developed earlier first gas passage (1.68 vs. 2.25 days, p = 0.041) and stool passage (2.10 vs. 2.80 days, p = 0.032). Group A also revealed shorter operating time (83.68 vs. 89.50 min, p = 0.040) and hospital stay (4.73 vs. 6.80 days, p = 0.001). None of the participants in both groups developed signs of bowel obstruction during the early and late postoperative follow‐up period. Conclusions Direct hand‐sewn repair for the closure of diverting loop ileostomy is a safe technique with better postoperative bowel function, oral diet tolerance, and less hospital stay compared to resection and hand‐sewn anastomosis of the ileum.

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“…Insufficient anastomotic blood supply and excessive tension are the key factors that lead to postoperative anastomotic fistula, [ 9 ] which causes thoracic and abdominal infection, results in transplantation failure and possible threats to the lives of the patients. [ 10 ] Anastomotic tear which emanates from severe coughing could be avoided through accurate management of analgesia and sedation.…”

Section: Case Presentationmentioning

confidence: 99%

“…Standardized airway management can effectively prevent infection and complications such as anastomotic fistula. [ 9 , 12 ] Using the minimum closure technique, respiratory therapists titrated the cuff pressure to 20 cm H 2 O. [ 12 ] The cuff pressure was monitored Q6h to avoid tracheal wall ischemia and compromised blood supply to transplanted organs.…”

Section: Case Presentationmentioning

confidence: 99%

Intensive care of a patient undergoing combined multi-organ cluster (“larynx–trachea–thyroid–hypopharynx–esophagus”) transplantation: A case report

Shen,

Liu,

Zhang

et al. 2024

Medicine

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Objective: The aim of this study was to summarize the intensive care experience of a patient undergoing combined multi-organ cluster (“larynx–trachea–thyroid–hypopharynx–esophagus”) transplantation. Methods: The intensive care management plan for this case was developed by a multidisciplinary team, with focus on 6 aspects: (1) stabilizing the circulation and reducing anastomotic tension by position management to improve the survival chances of transplanted organs, (2) adopting goal-directed analgesia and sedation protocols, as well as preventing anastomotic fistula, (3) implementing a bedside ultrasound-guided nutrition plan, (4) employing “body–mind” synchronous rehabilitation to facilitate functional recovery, (5) taking antirejection treatment and protective isolation measures, (6) monitoring and nursing thyroid function. Results: During the intensive care, the patient’s vital signs were stable. The patient was successfully weaned from the ventilator and transferred to the general ward for further treatment at 9 days postoperatively, and discharged upon recovery at 58 days postoperatively. The patient was in good condition during follow-up. Conclusion: This study provides reference for the care of patients who undergo similar transplantation in the future.

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The effect of suture techniques on the outcome of tracheal reconstruction: An observational study and review of literature

Cited by 7 publications

References 48 publications

Esophageal perforation etiology, outcome, and the role of surgical management – an 18-year experience of surgical cases in a referral center

Esophageal perforation etiology, outcome, and the role of surgical management – an 18-year experience of surgical cases in a referral center

Hand‐sewn direct repair versus resection and hand‐sewn anastomosis techniques for the reversal of diverting loop ileostomy after lower anterior rectal resection surgery: A randomized clinical trial

Intensive care of a patient undergoing combined multi-organ cluster (“larynx–trachea–thyroid–hypopharynx–esophagus”) transplantation: A case report

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