Tracheoplasty With Use of an Intercostal Muscle Flap for Caustic Necrosis

Naamee, Adel; Galvaing, Géraud; Chadeyras, Jean-Baptiste; Farhat, Mehdi; Page, Jean Philippe; Bony-Collangettes, Estelle; Tardy, Marie M.; Filaire, Marc

doi:10.1016/j.athoracsur.2015.04.138

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Six patients (54%) developed postoperative esophageal stricture, but all patients were able to take some or full oral nutrition (Lobeck et al 2016). Naamee et al (2015) reported the case of a 32-year-old male who underwent emergent total esogastrectomy, tracheostomy, and feeding jejunostomy following ingestion of a corrosive chemical substance. Ten days postoperative, bronchoscopy revealed complete tracheal mucosal destruction, extending from the tracheostomy to the carina.…”

Section: Surgical Interventionsmentioning

confidence: 99%

“…Under venovenous extracorporeal; membrane oxygenation, tracheal reconstruction was performed using a pedicled intercostal muscle flap. A flap biopsy specimen obtained 7 months postoperatively revealed ciliated neoepithelium (Naamee et al 2015). Ananthakrishnan et al (2014) reported a series of 105 patients with corrosive substance ingestions treated surgically with esophageal bypass without resection of the damaged esophagus between 1977 and 2008, noting that ingestion of acidic substances was the most common (70% of patients).…”

Section: Surgical Interventionsmentioning

confidence: 99%

See 1 more Smart Citation

Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

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Corrosive chemical substance ingestions are a major problem, especially in developing countries, but also in developed countries such as the United States, France, and Belgium. Ingestions may be deliberate as suicide attempts (mostly in adolescents and adults) or accidental (mostly in children). The results can be devastating in terms of individual suffering and disability, but also in terms of resource utilization and costs. In developing countries, outcomes may be worse because of limited medical/surgical resources. Common sequelae include gastrointestinal (GI) tract (esophagus, stomach, pylorus, and duodenum) stricture formation, GI tract perforation, and hemorrhage. Systemic effects may also occur, such as disseminated intravascular coagulation (DIC), multi-organ system failure, and sepsis. Various interventions in the acute phase to reduce the severity of injury have been attempted, but there are no large controlled clinical trials to demonstrate efficacy. Dilation therapy in various forms is commonly used for the treatment of strictures and a variety of surgical procedures including esophagectomy and delayed replacement may be required in severe corrosive injury cases.

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Section: Surgical Interventionsmentioning

confidence: 99%

Section: Surgical Interventionsmentioning

confidence: 99%

Corrosive substances ingestion: a review

Hall

Jacquemin²,

Henny³

et al. 2019

Critical Reviews in Toxicology

View full text Add to dashboard Cite

show abstract

Tracheoesophageal fistula due to a displaced external tracheal stent repaired using a local flap composed of intercostal muscle and rib periosteum

Yaguchi

Noguchi

Yasunaga³

et al. 2019

Journal of Pediatric Surgery Case Reports

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Extended autologous tracheal replacement by a novel pedicled thoraco-chondro-costal flap: a cadaveric proof of concept

de Frémicourt,

Wurtz,

Georgescu

et al. 2024

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Our aim was to report an anatomic model of an autologous flap based on the internal thoracic blood supply: the pedicled thoraco-chondro-costal flap; and establish the feasibility of various types of extended tracheal replacement with this novel flap, according to a newly-proposed topographic classification. METHODS In cadaveric model, a cervicotomy combined with median sternotomy was performed. The incision was extended laterally to expose the chest wall. The internal thoracic pedicle was freed from its origin down to the upper limit of the delineated flap to be elevated. The perichondria and adjacent periostea were incised longitudinally to remove cartilages and adjacent rib segments, preserving perichondria and periostea. A full-thickness quadrangular chest wall flap pedicled on internal thoracic vessels was then elevated and shaped into a neo conduit to replace the trachea with the pleura as an inner lining. RESULTS Various types of extended non-circumferential and full-circumferential tracheal replacements were achieved with this composite flap. No anastomosis tension was noticed despite the absence of release manoeuvres. CONCLUSIONS This model could represent a suitable autologous tracheal substitute, which is long, longitudinally flexible, and eventually transversely rigid. No microsurgical vascular anastomoses are required. The technique is reproducible. The perichondria and periostea would regenerate vascularized neo-cartilaginous rings, potentially decreasing the need for long-term stenting. The inner pleural lining could potentially transform into ciliated epithelium as shown in previous preclinical studies.

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Tracheoplasty With Use of an Intercostal Muscle Flap for Caustic Necrosis

Cited by 4 publications

References 6 publications

Corrosive substances ingestion: a review

Corrosive substances ingestion: a review

Tracheoesophageal fistula due to a displaced external tracheal stent repaired using a local flap composed of intercostal muscle and rib periosteum

Extended autologous tracheal replacement by a novel pedicled thoraco-chondro-costal flap: a cadaveric proof of concept

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