title: Treatment of large tracheal defects after resection: Laryngotracheal release and tracheal replacement.
abstract: OBJECTIVE
  Resection with direct tracheal or laryngotracheal anastomosis is the standard procedure employed for treatment of benign stenosis or occasionally primary or secondary tracheal malignancy.
  
  
  METHODS
  Literature review.
  
  
  RESULTS
  A tracheal anastomosis usually heals without complications provided that the ends being joined are adequately supplied with blood, an atraumatic suturing technique is used, and the anastomosis does not become infected. It is especially important that the anastomosis is not subjected to tension.
  
  
  CONCLUSIONS
  Various techniques of laryngeal and tracheal release serve to reduce the tension on the anastomosis by mobilizing and reducing the distance between the two segments to be approximated. These techniques can be used in different combinations depending on situation encountered during surgery. In cases where more than 50% of the tracheal length must be excised, prosthetic replacements, autologous tissue transfer and allografts are required. All present various problems. The use of tissue-engineering techniques utilizing autologous stem cells has opened new perspectives for tracheal replacement. Such procedures are still in an experimental state.
authors.affiliation: Department of Visceral, Thoracic and Vascular Surgery, Philipp University, Marburg, Germany. Electronic address: Kirschbaum001@gmx.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschbaum
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Afshin
authors.initials: A
authors.lastname: Teymoortash
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain; Fundación de Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.affiliation: Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.affiliation: Departments of Surgery and Otolaryngology - Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.affiliation: Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Nixon
authors.affiliation: University of Udine School of Medicine, Udine, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.
authors.forename: Luiz P
authors.initials: LP
authors.lastname: Kowalski
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
authors.forename: K Thomas
authors.initials: KT
authors.lastname: Robbins
authors.affiliation: Formerly Director of the Department of Surgical Sciences and Chairman of the ENT Clinic at the University of Udine School of Medicine, Udine, Italy; Coordinator of the International Head and Neck Scientific Group.
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D000714:Anastomosis, Surgical; D006801:Humans; D007830:Larynx / Q000601:surgery*; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures; D013536:Suture Techniques; D014132:Trachea / Q000601:surgery*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
keywords: Anastomotic tension; Laryngotracheal anastomosis; Tracheal replacement; Tracheal resection