Surgery Today

, 41:490

Tracheal resection for malignant and benign diseases: Surgical results and perioperative considerations

  • Takeshi Shiraishi
  • Jun Yanagisawa
  • Takao Higuchi
  • Masafumi Hiratsuka
  • Daisuke Hamatake
  • Naoyuki Imakiire
  • Toshiro Ohbuchi
  • Yasuteru Yoshinaga
  • Akinori Iwasaki
Original Article

DOI: 10.1007/s00595-010-4303-3

Cite this article as:
Shiraishi, T., Yanagisawa, J., Higuchi, T. et al. Surg Today (2011) 41: 490. doi:10.1007/s00595-010-4303-3

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.

Key words

Tracheal resectionReconstructionTracheal tumorTracheal stenosis

Copyright information

© Springer 2011

Authors and Affiliations

  • Takeshi Shiraishi
    • 1
  • Jun Yanagisawa
    • 1
  • Takao Higuchi
    • 1
  • Masafumi Hiratsuka
    • 1
  • Daisuke Hamatake
    • 1
  • Naoyuki Imakiire
    • 1
  • Toshiro Ohbuchi
    • 1
  • Yasuteru Yoshinaga
    • 1
  • Akinori Iwasaki
    • 1
  1. 1.Department of Thoracic, Endocrine and Pediatric SurgeryFukuoka University School of MedicineFukuokaJapan