Original articleGeneral thoracicImpact of Anastomotic Techniques on Airway Complications After Lung Transplant
Section snippets
Patient Information and Surgical Technique
This is a retrospective analysis of lung transplants performed at a single institution over the 4-year period from January 1, 2004, to December 31, 2008. Bilateral lobar and heart-lung transplants were excluded from this analysis. The general technique used has been described previously [11]. In the middle of this period (specifically, starting with a transplant performed on November 13, 2006), one surgeon at our institution (B.F.M.) altered his anastomotic technique with regard to the
Patient and Complication Details
The overall patient demographics for our patient population are outlined in Table 1. The majority of transplants performed at our institution are double lung transplants, and over this period, most were performed for emphysema. Of the 279 patients undergoing transplantation during this period, 20 (7.2%) had an airway complication, all of which were secondary to ischemic airway injury. The details of these complications are outlined in Table 2. The median number of interventions needed for
Comment
Although airway complications are not the frequent, catastrophic problem that they were in the early days of lung transplantation, they remain a significant source of morbidity and mortality. With the donor airway dependent on collateral blood flow in the postoperative period, it makes intuitive sense that shortening the donor airway before transplant would decrease the likelihood of ischemic injury to the bronchial anastomosis. There have been previous reports demonstrating the possibility of
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Risk factors and prognosis of airway complications in lung transplant recipients: A systematic review and meta-analysis
2023, Journal of Heart and Lung TransplantationPostoperative Bronchial Complications After Lung Transplantation Related to Anastomosis Suture
2022, Annals of Thoracic SurgeryAnastomotic Suturing Techniques and Their Association With Post–lung Transplantation Complications
2022, Journal of Surgical ResearchCitation Excerpt :As the use of LTx continues to rise, the safety and efficacy of this procedure must increase accordingly. A commonly cited problem after operation is the occurrence of bronchial complications, which increase both morbidity and mortality for patients who undergo LTx.8,9,12,16 One poorly understood factor of LTx is the efficacy of different suturing types used on bronchial anastomosis.
Airway Complications After Lung Transplantation
2021, Encyclopedia of Respiratory Medicine, Second EditionSingle running suture technique is associated with low rate of bronchial complications after lung transplantation
2020, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Several groups published their airway complication rates with and without shortening the donor bronchus. Using a single running suture, Van Berkel and colleagues7 described a complication rate of 8.2%, which dropped to 2.1% when the donor bronchus was cut at the level of the lobar carina. Furthermore, a propensity score matching of 48 patients receiving the modified technique compared with the standard technique proved the superiority of the first.