Abstract
Two cases of sleeve resection for tracheal obstruction in whom previous thoracic surgery had been performed are presented. The first case was a 56 year old male, had undergone left thoracoplasty at the age of 20. Resection of 9 tracheal carcilagenous rings with stenosis and end-to-end anastomosis of the trachea was performed. The stenosis was caused by endotracheal intubation when contract a hepatic coma. The second case was a 67-year-old male with metastatic tracheal carcinoma. Left lower lobectomy and mediastinal lymph node resection had been performed for lung cancer at the age of 65. Resection of 4 tracheal carcilagenous ring and end-to-end anastomosis of the trachea were performed. Preoperatively, both cases, there was worry concerning insufficient mobilization around the trachea due to severe adhesion resulting from the previous thoracic surgery. In the first case, collar incision with total mid-sternotomy was successfully performed for cervical tracheal stenosis. In the second case also, total mid-sternotomy was satisfactorily performed instead of a standard thoracotomy for a lower mediastinal tracheal obstruction. Based on our experience, we considered several problems concerning reconstruction of the trachea, a surgical approach and mobilization of the mediastinal trachea.
