Tracheal resection for malignant and benign diseases: surgical results and perioperative considerations.

Abstract:

PURPOSE:Tracheal surgery is an established treatment for various diseases; however, it is still a potentially challenging procedure. We herein discuss the safety of this procedure with regard to the coordination with airway interventional and anesthetic support. METHODS:A tracheal resection was performed on 18 patients. The dyspnea due to pre-existing severe airway stenosis, which was considered to be a risk factor for the safe induction of general anesthesia, was present in 12 (66.7%) cases. RESULTS:Seven of the 12 patients with pre-existing airway obstruction required interventional airway treatment before surgery. One case with a polyp-like tracheal tumor required venoarterial percutaneous cardiopulmonary support to establish adequate oxygenation before surgery. All 18 cases underwent a segmental resection of the trachea, with the average length of 3.6 rings. Postoperative recovery was uneventful for all but one patient with postintubation tracheal stenosis, who died 17 days after surgery due to a methicillin-resistant Staphylococcus aureus infection. Complications in the other patients included four cases of laryngeal nerve palsy, three of aspiration, and one patient with Horner syndrome, with a total morbidity of 27.7%. CONCLUSIONS:A tracheal resection is currently a safe procedure; however, cooperation with sophisticated airway interventional treatment teams, cardiopulmonary bypass support, or a well-trained anesthesiologist is essential for obtaining a successful outcome, especially for the cases with pre-existing severe airway obstruction.

journal_name

Surg Today

journal_title

Surgery today

authors

Shiraishi T,Yanagisawa J,Higuchi T,Hiratsuka M,Hamatake D,Imakiire N,Ohbuchi T,Yoshinaga Y,Iwasaki A

doi

10.1007/s00595-010-4303-3

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

490-5

issue

4

eissn

0941-1291

issn

1436-2813

journal_volume

41

pub_type

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