A technique which permits resection of almost half the trachea without intrathoracic prostheses has been developed by a Harvard Medical School surgical team at Massachusetts General Hospital.
Neither cardiopulmonary bypass nor postoperative tracheostomy has been needed in five patients according to Hermes C. Grillo, MD, assistant clinical professor of surgery.
The Harvard surgeons have removed from 2 to 5 cm of the trachea in treating either tumor or stenosis. However, cadaver experiments by the same group indicate that up to 6.4 cm might be safely excised— well over half the average 11 cm (4 1/4 inch) human trachea.
The operative approach differs according to whether the obstruction is mediastinal or cervical in location, Dr. Grillo noted. In either instance, anastomosis is reestablished with sutures "under tensions that are well within safe surgical limits.
"Previously, adequate resection has been inhibited by the impression that end-to-end sutures were not safe for greater