Abstract
Fourteen patients with tracheal lesions underwent primary reconstruction of the airway at the Hyogo Medical Center.
The tracheal resection ranging from 3 to 9 rings and end-to-end anastomoses were performed in 11 of the 14 patients, including in 3 cases of primary tumors of the trachea, 5 cases of secondary tumors and 3 postintubation strictures cases. Before operation, paralysis of the vocal cord was observed on one side in 4 patients and on both sides in 1. In three patients (2 of the former and 1 of the latter), the recurrent laryngeal nerve was found to be invaded bilaterally by the tumor during the operation and was resected on both sides. Of these 3 patients, one with an adenoid cystic carcinoma, in whom 9 rings were resected, underwent laryngectomy after eight-months of difficulty swallowing: one patient with esophageal cancer was managed well by use of a T-tube and another with thyroid cancer by tracheostomy.
Of the 14 patients, the remaining 3 with lesions of the tracheal membraneous portion underwent tracheoplasty successfully.
There was no operative death and no postoperative stenosis of the reconstructed trachea in any of the 14 patients. Surgeons should take care to preserve the recurrent laryngeal nerve and discuss the most appropriate method of anesthetization and reconstruction with the anesthetist before surgery.
