title: Reverse telescope anastomotic technique reduces the incidence of bronchial stricture.
abstract: BACKGROUND
  Bronchial stricture remains a major problem after lung transplantation. We hypothesized that a "reverse" telescope anastomosis, where the donor bronchus is sleeved external to the recipient bronchus, would be associated with a lower incidence of anastomotic stricture.
  
  
  METHODS
  Over a 12-month period our Unit performed 35 consecutive single and bilateral sequential lung transplantations. The 56 bronchial anastomoses were constructed as a conventional (n = 27) or as a reverse (n = 29) telescope.
  
  
  RESULTS
  Bronchial strictures developed in 48% of the conventional anastomoses but in only 7% of the reverse anastomoses (p < or = 0.05). Furthermore, the reverse telescope anastomosis eliminated the need for stenting.
  
  
  CONCLUSIONS
  This technique greatly reduced the need for dilatation, debridement, and stent placement and may reduce the morbidity and mortality associated with anastomotic complications.
authors.affiliation: Heart & Lung Transplant Services, Alfred Hospital, Prahran, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Rabinov
authors.forename: D S
authors.initials: DS
authors.lastname: Esmore
authors.forename: G I
authors.initials: GI
authors.lastname: Snell
authors.forename: R F
authors.initials: RF
authors.lastname: Salamonsen
authors.forename: A
authors.initials: A
authors.lastname: Griffiths
authors.forename: T
authors.initials: T
authors.lastname: Williams
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods*; D001982:Bronchial Diseases / Q000517:prevention & control*; D001999:Bronchoscopy; D003251:Constriction, Pathologic / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D015607:Stents; D013536:Suture Techniques