Tracheal surgery

D’Andrilli, Antonio; Rendina, Erino Angelo; Venuta, Federico

doi:10.4081/monaldi.2010.294

Cited by 15 publications

(22 citation statements)

References 41 publications

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“…2-5 Treatment is balanced between establishing durable airway patency and minimizing risks and complications. There is a propensity for recurrent stenosis after intervention, 6-9 and management remains heterogeneous and controversial among treating physicians. 3,10 Medical and surgical treatments are employed, often in combination.…”

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confidence: 99%

Idiopathic Subglottic Stenosis: An Institutional Review of Outcomes With a Multimodality Surgical Approach

Dwyer

Qiabi

Fortin

et al. 2020

Otolaryngol.--head neck surg.

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Objectives This article reports on a unique cohort of patients with idiopathic subglottic stenosis spilt fairly equally between endoscopic and open surgical approaches. Patients’ sequence of operations and reinterventions over time are outlined, offering insight to improve surgical counseling and allow for informative, autonomous patient decision making. Study Design Retrospective cohort study. Setting Tertiary care academic center. Methods Cases of consecutive adults with idiopathic subglottic stenosis managed surgically over a 12-year period (January 2006–December 2017) were retrospectively reviewed. Surgical workflow, complications, and outcomes, including reinterventions and tracheotomy dependence, are reported. Results Seventy-two patients (71 women; mean age, 50.4 years) with idiopathic subglottic stenosis requiring surgical airway intervention were identified. Six patients underwent tracheotomy prior to attempt at airway stenosis surgery. Initial surgical approach thereafter included endoscopic (73.5%, n = 53) and open (26.4%, n = 19) procedures. Thirty-one patients underwent cricotracheal resection; the reintervention rate was 22.5%. Sixty patients underwent 147 endoscopic procedures; the reintervention rate was 75.5%, and the mean time between dilations was 83 weeks (range, 5-402). Two (2.8%) patients remain tracheotomy dependent. Adverse events were significantly higher in the cricotracheal group, especially with respect to dysphonia and temporary gastrostomy tube placement ( P < .01). Conclusions Endoscopic and open surgical airway intervention can be employed successfully to avoid tracheotomy dependence and maintain airway patency; however, multiple procedures are usually required, regardless of surgical approach. Cricotracheal reintervention rates are lower than endoscopic dilation but with increased morbidity. Quality-of-life outcomes should be clearly discussed with patients before deciding on a surgical management strategy.

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mentioning

confidence: 99%

Idiopathic Subglottic Stenosis: An Institutional Review of Outcomes With a Multimodality Surgical Approach

Dwyer

Qiabi

Fortin

et al. 2020

Otolaryngol.--head neck surg.

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“…Whether benign or malignant tracheal tumors, surgical resection and removal of respiratory obstruction is the first choice for treatment (6). R0 resection means negative margin, which is the critical prognostic factor for long-term survival of patients with tracheal tumors (7).…”

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia: a case report

Jia¹,

Zhou²,

Liu³

et al. 2022

Shanghai Chest

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Background: Primary tracheal tumors are very rare, surgical treatment is the first choice, and the extent of resection and anastomosis is determined by the location, shape and size and pathological result of the tumor. With the rapid development of minimally invasive techniques and instruments in video-assisted thoracoscopic surgery, but tracheal surgery is usually considered to be the most challenging and complex thoracic surgery, which requires not only extraordinary surgical skill, but also good anesthesia management performed by anesthesiologists. Few studies have reported the safety and effectiveness of VATS resection and reconstruction of the tracheal.Case Description: Here we report a case of 47-years female, complaining of cough and short of breath for three months. Bronchoscopy showed a tracheal neoplasm located in the lower trachea, 2 cm away from carina, biopsy result was adenoid cystic carcinoma,and other examinations showed no distant metastasis.After MDT discussion, our surgical team performed 3-port VATS tracheal tumor resection and end-to-end anastomosis with acupuncture drug compound non-intubated anesthesia, our anesthesia team performed spontaneous breathing anesthesia with laryngeal mask to protect the airway, closely observing and prepared for intubation in case of emergency. The patient recovered well with no complication. Conclusion:Our initial experience of VATS tracheal tumor resection and anastomosis with acupuncture drug compound non-intubated anesthesia showed technically safe and feasible. No-intubation anesthesia would reduce damage of the tracheal and ventilator-related lung injury, and acupuncture drug stimulationassisted anesthesia would reduce the dosage of opioids, enhance recovery of patient.

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“…Das häufigste Problem nach Trachearesektionen ist eine wiederkehrende Stenose mit der Notwendigkeit von interventionellen Dilatationen, Stentanlage, Reoperationen und vorübergehenden oder permanenten Tracheotomien. Insgesamt werden die postoperativen Ergebnisse in erfahrenen Zentren mit bis zu 95 % exzellent und gut angegeben [22], [25], [40], [42], [43], [44].…”

Section: Perikardiophrenische Mobilisierungunclassified

Chirurgie der Trachea

Volmerig¹,

Hecker²

2019

Laryngo-Rhino-Otol

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ZusammenfassungDie Chirurgie der Trachea ist ein Spezialgebiet, in dem aufgrund der Vielzahl von Indikationen und der erweiterten Topografie viele Disziplinen gemeinsam tätig sind. Nicht nur wegen der besonderen funktionellen Bedeutung, sondern auch wegen seiner komplexen Morphologie, Anatomie und Physiologie stellt dieses Organ eine besondere therapeutische Herausforderung dar. Eine Vielzahl von Krankheiten erfordert chirurgische Eingriffe der Trachea – sowohl die Krankheit selbst als auch patientenabhängige Parameter beeinflussen die therapeutische Strategie. Unabhängig von der Art der zugrunde liegenden Erkrankung erfordert es eine hohe Expertise im Luftwegmanagement, eine sorgfältige Diagnose und interventionelle Planung sowie ein erfahrenes OP-Team mit Beherrschung der erweiterten Operationstechniken, um gute Ergebnisse zu erzielen. Zur optimalen Therapieentscheidung ist immer eine multidisziplinäre Bewertung der individuellen Situation durch den interventionellen Pneumologen, den Thoraxchirurgen, den Viszeralchirurgen, HNO-Chirurgen und Anästhesisten erforderlich.

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Tracheal surgery

Cited by 15 publications

References 41 publications

Idiopathic Subglottic Stenosis: An Institutional Review of Outcomes With a Multimodality Surgical Approach

Idiopathic Subglottic Stenosis: An Institutional Review of Outcomes With a Multimodality Surgical Approach

Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia: a case report

Chirurgie der Trachea

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