Scar Carcinoma of the Trachea after Tracheotomy

Theegarten, Dirk; Freitag, Lutz

doi:10.1159/000196210

Cited by 6 publications

(2 citation statements)

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“…6,4 cm) k6nnen re--seziert werden, ohne dab nach ausreichender Mobilisation und Anlage einer End-zu-End-Anastomose eine Trachealdehiszenz oder Nahtinsuffizienz zu beffirchten ist [2,19,21,22]. Die Rekonstruktion gr61~erer Trachealdefekte nach Tumorresektion stellt ein bis heute klinisch ungel6stes Problem dar, obgleich zahlreiche experimentelle Einzelstudien durchgeftihrt wurden [1,2,4,15,26,35,36,54,55]. Im Falle prim~ir nicht rekonstruierbarer Trachealdefekte steht der Einsatz alloplastischer und homologer Transplantate zur Diskussion.…”

Section: Diskussionunclassified

“…des Truncus brachiocephalicus oder der V. anonyma und hoher Inzidenz yon Restenosierungen durch Granulombildungen als definitive Therapie ungeeignet und wenigen AusnahmefNlen vorbehalten. Eine prothetische Rekonstruktion ist nur dann indiziert, wenn nach pr~ioperativ unvorhersehbarer extensiver Trachearesektion trotz Larynx-und Hilusmobilisation keine pfimfire Anastomisierung m6glich ist [2,54].…”

Section: Diskussionunclassified

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Maligne trachealtumoren ? chirurgische Erfahrung bei 6 Patienten mit prim�ren Malignomen der Trachea

Teschner

1996

Langenbecks Arch Chir

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In a retrospective study six patients with malignant tumours of the trachea located distal to the cricoid and proximal to the carina tracheae were operated on during the period of December 1983 to July 1995 in the Department of Thoracic Surgery in Hannover (Heidehaus). Histopathological examination revealed two adenoid cystic carcinomas, two squamous cell carcinomas, one mucoepidermoid carcinoma, and one low-grade sarcoma. Laser bronchoscopic resection was performed in one patient and tracheotomy one other avoid imminent asphyxia. Physical examination mainly showed a range of symptoms such as stridor and dyspnoea; spirography showed increased airway resistance, and X-ray of the trachea was important in the diagnostic process. The tracheal tumours were diagnosed by histopathological examination of excised material obtained by bronchoscopy. Three patients underwent resection and primary reconstruction of the trachea, with a length of resection between 2.0 and 3.5 cm and end-to-end anastomosis. Endotracheal afterloading was necessary in the case of one female patient with tumour infiltration of the proximal end of the upper trachea. Neoadjuvant irradiation was followed by resection of the whole trachea and implantation of a tracheal prosthesis (Neville) in the case of a patient with extensive endo- and extraluminal tumour infiltration. An extensive recurrence led to the death of this patient 5 months after the surgical intervention. Because of the distal location, resection of the tracheal bifurcation was necessary in two patients, in one combined with a pneumonectomy on the right side. Stenosis of the main bronchus and development of granuloma made stent implantation unavoidable. Dislocation of the stents and recurrent pneumonia caused the patients deaths 74 days and 18 months postoperatively. On follow up 17, 93, and 120 months postoperatively none of the other patients had recurrences. Current diagnostic and therapeutic options for malignant tracheal tumours are discussed.

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