Some technical suggestions in carinal reconstruction

Abstract

It has been reported that anastomotic complications of carino plasty occur at a high rate. In this study we aimed to prevent the complications, avoiding excessive tension and deformation of the anastomotic site.
The carino plasty by Grill's procedure often has separation or stenosis of the bronchial anastomosis to the side of the trachea. Then a continuous suture was employed instead of interrupted sutures so as not to induce excessive tension at a few sutures.
On the wedge carinal resection, when the membranous trachea is folded to compensate for disparity of the lumen, complications of anastomosis often developed.
Therefore the cartilaginous portion of the trachea was cut as a wedge-shaped piece to reduce the opening diameter.
In addition, telescopic anastomosis was carried out between the trachea and bronchus in both cases.
Anastomotic problems, such as granulation, stenosis and separation were not observed with bronchofiberscope after operation.