Our aim was to analyze the results of laryngotracheal reconstruction as a treatment for complex laryngotracheal stenosis in adults, considering postoperative and long-term outcome.
Methods: Laryngotracheal reconstruction (laryngeal split with anterior and posterior interposition of a rib cartilage graft) has been used in our institution to manage glottic/subglottic stenosis restricted to the larynx; laryngotracheal reconstruction associated with cricotracheal resection has been used to treat glottic/subglottic/upper tracheal stenosis (extending beyond the second tracheal
ring). A retrospective study was conducted, including all patients with complex laryngotracheal stenosis treated surgically in our institution from January of 2002 until December of 2005.
Results: Twenty
patients (10 male Selleckchem OSI-027 and 10 female patients; average age, 36.13 years; age range, 18-54 years) were included. There were no deaths, and the postoperative complications were as follows: dysphonia, 25%; subcutaneous emphysema, 10%; tracheocutaneous fistula, 20%; wound infection, 15%; and bleeding, 5.0%. Eighty percent of the patients were completely decannulated after a mean of 23.4 months of follow-up (range, 4 -55 months).
Conclusions: Laryngeal split with anterior and posterior cartilage graft interposition as an isolated procedure or associated with a cricotracheal resection is a feasible and low-morbidity alternative for complex laryngotracheal stenosis treatment.”
“Objective: Lung ischemia-reperfusion injury selleck chemical is associated with impaired gas exchange DNA-PK inhibitor from increased edema formation and surfactant inactivation. Surfactant replacement therapy is believed to improve gas exchange and lung function, but its effect on inflammation is less well understood. We therefore examined the effects
of exogenous surfactant on inflammatory and apoptotic factors in the lung in a rat model of lung ischemia-reperfusion injury.
Methods: The left lung in rats was subjected to ischemia for 120 minutes and reperfusion for as long as 240 minutes. Sham-treated animals underwent sham surgery and mechanical ventilation for equivalent times. Rats received porcine surfactant or saline solution intratracheally either before or just after ischemia. Lungs were analyzed histopathologically and for expressions of inducible nitric oxide, cytokines, and caspase-3.
Results: Lung ischemia-reperfusion injury resulted in worse lung histopathologic characteristics than in sham-operation animals. At 2 hours of reperfusion, lung ischemia-reperfusion injury animals showed increased pulmonary caspase-3 expression. Moreover, lung ischemia-reperfusion injury resulted in inducible nitric oxide expression at all time points. Exogenous surfactant resulted in less inflammatory cell infiltration and edema in the lungs relative to saline-treated animals.