REVERSE TELESCOPE ANASTOMOTIC TECHNIQUE REDUCES THE INCIDENCE OF BRONCHIAL STRICTURE

Background: Bronchial stricture remains a major problem after lung tra nsplantation. We hypothesized that a ''reverse'' telescope anastomosis , where the donor bronchus is sleeved external to the recipient bronch us, would be associated with a lower incidence of anastomotic strictur e. Methods: Over a 12-month period our Unit performed 35 consecutive s ingle and bilateral sequential lung transplantations. The 55 bronchial anastomoses were constructed as a conventional (it = 27) or as a reve rse (n = 29) telescope. Results: Bronchial strictures developed in 48% of the conventional anastomoses but in only 7% of the reverse anastom oses (p less than or equal to 0.05). Furthermore, the reverse telescop e anastomosis eliminated the need for stenting. Conclusions: This tech nique greatly reduced the need for dilatation, debridement, and stent placement and may reduce the morbidity and mortality associated with a nastomotic complications.