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Ann Thorac Surg 2007;84:215
© 2007 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Invited commentary

Thoracic Surgery, University La Sapienza, Ospedale Sant’Andrea, Via di Grottarossa, Rome, 1035 00189 Italy

(Email: erinoangelo.rendina{at}uniroma1.it).

It is the experience of all thoracic surgeons who have an interest in tracheal surgery to deal occasionally with multi-segmental tracheal stenosis (MTS). These patients are extremely difficult to treat for the heterogeneity of the tracheal lesions and because personal experience is generally very limited.

The authors [1] should be congratulated for focusing on this rare condition and on reporting their important experience, which is the most consistent in the literature. It is important to note that the 26 patients with MTS represent only 4% of 648 patients treated during the relatively short period of 2 years. This means that the clinical judgement (a key point in this disease) is corroborated by a huge experience in tracheal surgery. Experience in tracheal surgery and wise clinical judgement is consequently the explanation for the excellent results obtained in 61.5% of the patients.

When the surgical option is selected, the operation is technically difficult; although the authors unfortunately do not mention the surgical access nor the release maneuver they used, they were able to resect a mean of 6 cm of the trachea with a maximum of as much as 9 cm, far beyond an average tracheal resection.

If a conservative strategy is preferred, surgeons must be aware that the risk of mortality is not avoided; in fact the 3 patients who died (11.6%) belong to the group where some form of conservative treatment was used.

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1. Abbasidezfouli A, Shadmehr MB, Arab M, et al. Postintubation multisegmental tracheal stenosis: treatment and results Ann Thorac Surg 2007;84:211-215.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Erino A. Rendina Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rendina, E. A. Search for Related Content PubMed PubMed Citation Articles by Rendina, E. A. Related Collections Trachea and bronchi Related Article