Experience with surgical treatment of 164 patients with various diseases of the trachea at the All-Union Institute of Clinical and Experimental Surgery in Moscow since 1963 is summarized. The main diagnostic methods used in tracheal diseases were tracheography and tracheoscopy with biopsy. Operations were performed for malformation, trauma, exflammatory disease, benign and malignant tumors, nontumoral stenoses, and esophagotracheal fistula. A bypass respiration system was used in the majority of patients after tracheal transection. Hyperbaric oxygenation added to the bypass respiration system made it possible to interrupt lung ventilation during operations on the trachea for long periods.The best operative approach to the thoracic trachea was a partial sternotomy and posterior thoracotomy. The standard approach to the tracheal bifurcation was a posterior right thoracotomy.The various operations performed on the trachea included sleeve resection with end-to-end anastomosis, resection of the tracheal bifurcation, window resection, tumoral incision in the opened trachea, plastic repair of esophagotracheal fistula, and strengthening of the membranous trachea. Six variations of resection of the tracheal bifurcation were performed. In cases of sleeve resection, operative risk was minimized by suturing the left main bronchial stump closed, leaving the left lung in a state of atelectasis.Of the 164 patients who underwent operation, 138 were discharged from the hospital and 26 (16%),died in the postoperative period. Bleeding from the brachiocephalic artery, pneumonia, thromboembolism of the pulmonary artery, and anastomotic leak were the causes of death. Op-Translated by Jerome Katsell, Ph.D.
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