Ludwig C, Koryllos A, Zalepugas D, Stoelben E. [Review of the Literature for Interpretation of Endobronchial Wound Healing after Tracheobronchial Sleeve Resection].
Pneumologie 2015;
69:403-8. [PMID:
26171714 DOI:
10.1055/s-0034-1392313]
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Abstract
Sleeve resection comprises 3.1 % to 27.7 % of all anatomic lung resections performed in Germany. Anastomotic insufficiency is a feared complication that should be avoided. When anastomotic insufficiency does lead to secondary pneumonectomy, postoperative morbidity and mortality is high (30 % to 80 %). It is therefore very important to standardize the technique of sleeve resection as well as postoperative care. The time-point of postoperative follow-up and the interpretation of endobronchial healing have not yet been defined. In this paper anastomotic healing is described and interpreted with the help of a 5-step classification that allows bronchoscopic evaluation and classification of the anastomosis. The aim is to provide a standardized algorithm for postoperative care after sleeve resection. The basis of this classification and postoperative care measures derived from it are described and illustrated with the help of clinical examples.
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