Eur J Cardiothorac Surg 2004;26:1060-1061
© 2004 Elsevier Science NL
Reply to Pramesh et al.
Arpad Pereszlenyia,*,
Martin Igazb,
Ivan Majerc,
Svetozar Harustiaka
a Clinic of Thoracic Surgery, National Tuberculosis and Respiratory Diseases, Institute Bratislava, Slovak Republic
b Department of Pathology, Comenius University of Bratislava, Bratislava, Slovak Republic
c Department of Bronchoscopy, National Tuberculosis and Respiratory Diseases Institute, Bratislava, Slovak Republic
Received 30 July 2004;
accepted 5 August 2004.
* Corresponding author. Tel.: +421-907-127-697; fax: 421-2-452-436-22. (E-mail: arpad_pp{at}hotmail.com).
We would like to thank Pramesh and colleagues [1] for the critical and valuable comments, which also closely target the issue in question. We fully agree with their opinion on choices of an optimal stent, its characteristics, its ability to create granulation tissue, etc. and on the choice/timing of surgery summarized in the first part of their letter given in four points.
Our article [2] is an institutional review of experiences in tracheal reconstruction surgery within the period of 12 years. This retrospective review is mainly focused on stenting by our own modification of Montgomery T-tube applied in 65 cases (from total of 163). There are detailed analyses as well as description of patients and methods, procedures, results given in our four sections (divided into 10 sub-sections), so the reader besides other information can easily find what are our criteria for the T-tube applications (incication criteria) as well as for its removal. However, in order to reply the letter of Pramesh et al. [1], we can briefly summarize our indications for T-tube removal: stabilized tracheal wall (without tendency of its re-stenosis), normal (healed) tracheal mucosa without granulation formations. Further criteria concern the general status of the individual, and here the cooperation of the patient and his ability to actively cough is the most important. Each individual case must be treated separately and the whole procedure is rather time-consuming.
To conclude we would wish to react to a remark from the letter [1]—Dumon and Montgomery T-tube are in fact invaluable in stenting lesions, which are too long, as it was proved in our study. Its application often remains the only possible solution for patients with tracheal stenosis in apparently deadlock situations.
References
- Pramesh CS, Mistry RC, Upasani VV. Stents and sensibility—use of the Montgomery T-tube in tracheal stenosis. Eur J Cardiothorac Surg 2004.
- Pereszlenyi A, Igaz M, Majer I, Haru
tiak S. Role of endotracheal stenting in tracheal reconstruction surgery-retrospective analysis. Eur J Cardiothorac Surg 2004;25:1059-1064.[Abstract/Free Full Text]
