A more conservative technique for anterior mediastinal tracheostomy after sub-total resection of the trachea.

Abstract:

:Anterior mediastinal tracheostomy (AMT) is a rare but challenging operation associated with a high morbidity and mortality rate mainly related to the invasiveness of the procedure. In order to provide a more conservative technique with a lower risk of major postoperative complications, we proposed: (1) to reduce the extent of chest wall resection to only a trapezoidal segment of the manubrium; (2) to use a simple pedicle pectoralis major flap instead of myocutaneous or omental flaps; and (3) to perform a simple relocation of the residual trachea (RT) below the brachiocephalic artery instead of artery ligation, percutaneous stent placement or replacement by cadaveric allograft. This technique was used in a patient with cancer recurrence at the cervical stoma after total laryngectomy. Despite a short 2.5-cm RT, it was possible to perform AMT without any tension at the mediastinal stoma. Postoperative course showed only regressive minor complications. There was no late complication related to the procedure with a one-year follow-up. This more conservative technique for AMT could be used as an alternative to previously described procedures in order to reduce postoperative complications and mortality rate after sub-total resection of the trachea.

authors

Martinod E,Guillaume JY,Radu DM,Despreaux G

doi

10.1510/icvts.2010.260588

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

672-5

issue

5

eissn

1569-9293

issn

1569-9285

pii

icvts.2010.260588

journal_volume

12

pub_type

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