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1.
Artículo en Chino | MEDLINE | ID: mdl-33794609

RESUMEN

Objective:To investigate the risk factors affecting the surgical outcome of severe tracheal stenosis. Methods:The data of 36 patients with severe tracheal stenosis were analyzed retrospectively. All patients underwent tracheal stenosis resection with primary end-to-end anastomosis.Six factors including the location of tracheal stenosis, the length of resected trachea, the degree of stenosis, scar constitution, diabetes and gastroesophageal reflux disease were analyzed by univariate analysis and multivariate Logistic regression analysis. Results:Finally, 23 cases were extubated,including 19 cases with successful extubation and 4 cases with granulation tissue removed by bracing laryngoscope.Univariate analysis showed that the location of tracheal stenosis, the length of resected trachea,scar constitution, diabetes and gastroesophageal reflux disease were the risk factors affecting the surgical efficacy of severe tracheal stenosis.The multivariate Logistic regression coefficients of each factor were 2.857, 1.761, 3.123, -1.066, 3.545 respectively. Conclution: The risk factors affecting the outcome of severe tracheal decannulation rate were the location of tracheal stenosis, the length of resected trachea, scar constitution, diabetes and gastroesophageal reflux disease. Among them, the stenosis position, the length of the resected trachea, scar constitution and gastroesophageal reflux disease had more significant effects on the prognosis of the operation, and the comprehensive evaluation of these risk factors before operation was conducive to improve the surgical effect.


Asunto(s)
Estenosis Traqueal , Anastomosis Quirúrgica , Humanos , Estudios Retrospectivos , Factores de Riesgo , Tráquea/cirugía , Estenosis Traqueal/cirugía , Resultado del Tratamiento
2.
Medicine (Baltimore) ; 100(11): e25132, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725993

RESUMEN

ABSTRACT: The aim of this study was to evaluate the effectiveness and safety of a partially covered metallic tracheal Y-shaped stent for the treatment of high cervical gastro-tracheal fistula (GTF) and tracheo-esophageal fistula (TEF). From January 2017 to January 2019, 16 patients with high cervical GTF and TEF received partially covered metallic Y-shaped stent placement under fluoroscopic guidance. The technical and clinical success rates, incidence of major complications, and survival outcomes were analyzed. Eastern Cooperative Oncology Group (ECOG) score and quality of life (SF-36 questionnaire) were compared pre and post stent placement. Technical and clinical success rates were 100% and 81.3%, respectively. Major complications (severe tumor ingrowth, mucostasis, hyperplastic granulation tissue) occurred in 7/16 (43.8%) patients. ECOG score and 5 of the 8 domains of the SF-36 (physical function, role physical, general health, vitality, social function) were significantly improved at 1 month after treatment (P < .01). During the median follow-up period of 8.3 months, 9 patients were alive. Median overall survival was 10.3 months (95% CI, 8.0-12.6). The newly designed partially covered tracheal Y-shaped stent appears to be effective and safe for treatment of high cervical GTF and TEF.


Asunto(s)
Fístula Gástrica/cirugía , Fístula del Sistema Respiratorio/cirugía , Stents Metálicos Autoexpandibles , Tráquea/cirugía , Traqueotomía/instrumentación , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello/cirugía , Diseño de Prótesis , Estudios Retrospectivos , Enfermedades de la Tráquea/cirugía , Fístula Traqueoesofágica/cirugía , Traqueotomía/métodos , Resultado del Tratamiento
3.
Laryngoscope ; 131(3): E719-E723, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33593035

RESUMEN

OBJECTIVES: Tracheal A-frame deformity is a known consequence of tracheostomy that may lead to obstruction after decannulation. The goal of this study is to demonstrate the feasibility and success of endoscopic carbon dioxide (CO2 ) laser-assisted tracheoplasty of tracheal A-frame deformity in children. METHODS: Retrospective case series of symptomatic children with tracheal A-frame deformity with no other site of airway obstruction (2016-2018). All patients underwent CO2 -laser assisted endoscopic resection tracheoplasty. RESULTS: Eight patients (six male) were included with a median age of 15.4 (IQR 12.3-17.9) years. Patients had a median of two previous open airway surgeries (IQR 1-2.5) and all patients had a history of tracheostomy with successful decannulation. Tracheal A-frame deformity presented as dyspnea on exertion for all patients (n = 8, 100%). Obstructive sleep apnea was confirmed for all patients who underwent polysomnography (4/4, 100%). Median interval from decannulation to development of symptoms was 8.7 years (IQR 5.8-9.3). All patients sized with an age-appropriate endotracheal tube despite the deformity. Endoscopic A-frame tracheoplasty was successful for 7/8 (87.5%) patients and was performed with overnight observation for these patients (8/8, 100%). Unilateral A-frame tracheoplasty was performed successfully for five patients (62.5%), bilateral A-frame tracheoplasty was performed successfully for two patients (25.0%), and one patient (12.5%) did not have complete resolution of symptoms after bilateral A-frame tracheoplasty due to multi-level airway obstruction. CONCLUSIONS: CO2 laser-assisted tracheoplasty is an innovative endoscopic technique to relieve symptoms of airway obstruction for selected patients with tracheal A-frame deformity although avoiding the morbidity and hospital stay duration associated with tracheal resection. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E719-E723, 2021.


Asunto(s)
Obstrucción de las Vías Aéreas/cirugía , Endoscopía/métodos , Láseres de Gas/uso terapéutico , Complicaciones Posoperatorias/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Tráquea/anomalías , Adolescente , Extubación Traqueal/efectos adversos , Obstrucción de las Vías Aéreas/etiología , Niño , Estudios de Factibilidad , Femenino , Humanos , Masculino , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Tráquea/cirugía , Traqueostomía/efectos adversos , Resultado del Tratamiento
4.
J Vis Exp ; (168)2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33616107

RESUMEN

Fetal tracheal occlusion (TO), an established treatment modality, promotes fetal lung growth and survival in severe congenital diaphragmatic hernia (CDH). Following TO, retention of the secreted epithelial fluid increases luminal pressure and induces lung growth. Various animal models have been defined to understand the pathophysiology of CDH and TO. All have their own advantages and disadvantages such as the difficulty of the technique, the size of the animal, cost, high mortality rates, and the availability of genetic tools. Herein, a novel transuterine model of murine fetal TO is described. Pregnant mice were anesthetized, and the uterus exposed via a midline laparotomy. The trachea of selected fetuses were ligated with a single transuterine suture placed behind the trachea, one carotid artery, and one jugular vein. The dam was closed and allowed to recover. Fetuses were collected just before parturition. Lung to body weight ratio in TO fetuses was higher than that in control fetuses. This model provides researchers with a new tool to study the impact of both TO and increased luminal pressure on lung development.


Asunto(s)
Embrión de Mamíferos/cirugía , Fetoscopía/métodos , Feto/cirugía , Hernias Diafragmáticas Congénitas/cirugía , Pulmón/crecimiento & desarrollo , Modelos Animales , Tráquea/cirugía , Animales , Femenino , Pulmón/embriología , Ratones , Embarazo
5.
Khirurgiia (Mosk) ; (2): 32-39, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33570352

RESUMEN

OBJECTIVE: To assess the tracheal elasticity and tracheal anastomosis tension for prevention of anastomosis-related complications and estimation of the maximum length of resection. MATERIAL AND METHODS: At the first stage, 20 patients with cicatricial tracheal stenosis underwent tracheoscopy in usual position, under maximum flexion and extension of the head for the period from September 2017 to December 2019. We measured the total length of trachea and length of stenotic segment. Tracheal extensibility was assessed considering the difference in measurements. At the second stage, anastomosis tension was intraoperatively measured using a dynamometer in normal head position, as well as at maximum flexion in 22 patients who underwent tracheal resection. Unlike multiple other studies, we studied tissue tension intraoperatively. RESULTS: Mean length of trachea was 12.8 cm, extensibility - 1.3 cm. Tracheal elasticity was greater in patients with a longer trachea and in patients under 40 years old. Mean length of resection was 3.9 cm (30% of mean length of trachea), anastomosis tension - 2.7 H or 270 g. Head flexion was followed by tension decrease by 0.7 H (26.9%), i.e. 70 g. This approach is less effective in case of resection of more than 30% of trachea length in a particular patient. CONCLUSION: Further experience in measurement of tracheal extensibility and anastomosis tension will make it possible to establish clinical significance of these indicators for prevention of complications.


Asunto(s)
Anastomosis Quirúrgica/efectos adversos , Elasticidad , Tráquea , Estenosis Traqueal , Adulto , Cicatriz/patología , Cicatriz/cirugía , Constricción Patológica/patología , Constricción Patológica/cirugía , Endoscopía , Humanos , Tamaño de los Órganos , Rango del Movimiento Articular , Tráquea/patología , Tráquea/cirugía , Estenosis Traqueal/diagnóstico , Estenosis Traqueal/etiología , Estenosis Traqueal/cirugía
6.
Gen Thorac Cardiovasc Surg ; 69(4): 762-765, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33389572

RESUMEN

We report successful engraftment by autologous transplantation of the bronchial wall of the resected specimen in extensive tracheobronchial resection with left pneumonectomy. Since the adenoid cystic carcinoma had spread beyond the carina to the right bronchus, we resected three rings of tracheal cartilage and three rings of left main bronchus cartilage. Reconstruction was performed using the bronchial wall of the resected specimen to relieve tension on the anastomosis. No stricture or recurrence was observed four years after the operation. Further research relating to maximization of blood flow to the reconstructed tissue based on engraftment area and shape is required.


Asunto(s)
Neoplasias de los Bronquios , Recurrencia Local de Neoplasia , Autoinjertos , Bronquios/diagnóstico por imagen , Bronquios/cirugía , Neoplasias de los Bronquios/diagnóstico por imagen , Neoplasias de los Bronquios/cirugía , Humanos , Neumonectomía , Tráquea/cirugía , Trasplante Autólogo
7.
J Laryngol Otol ; 135(2): 185-188, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33487184

RESUMEN

OBJECTIVE: To highlight the importance of imaging in reducing an accidental injury to the anomalous brachiocephalic trunk and its branches during tracheal surgery. CASE REPORT: This paper reports two cases of accidental injury to the great vessels in the neck during tracheal surgery. The first incident occurred during a repeat tracheostomy, when the right common carotid artery was injured. On reviewing the computed tomography images, the bifurcation of the brachiocephalic artery was seen to the left of the midline, and the right common carotid artery was adherent just below the tracheostomy site. The second incident happened during surgery for tracheal stenosis, when there was an inadvertent injury to the main brachiocephalic trunk, which was adherent to the trachea in the lower neck region. CONCLUSION: For airway surgeons, radiological assessment of vascular structures in relation to the trachea prior to surgery is as important as the endoluminal airway assessment for the best outcome.


Asunto(s)
Lesiones Accidentales/prevención & control , Tronco Braquiocefálico/anomalías , Cuello/cirugía , Tráquea/cirugía , Estenosis Traqueal/cirugía , Lesiones Accidentales/epidemiología , Tronco Braquiocefálico/diagnóstico por imagen , Tronco Braquiocefálico/lesiones , Tronco Braquiocefálico/cirugía , Traumatismos de las Arterias Carótidas/epidemiología , Traumatismos de las Arterias Carótidas/prevención & control , Arteria Carótida Común/anomalías , Arteria Carótida Común/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuello/irrigación sanguínea , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/normas , Estenosis Traqueal/diagnóstico por imagen , Traqueostomía/efectos adversos , Resultado del Tratamiento
9.
Medicine (Baltimore) ; 100(2): e24070, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466165

RESUMEN

ABSTRACT: Locally invasive thyroid carcinoma (TC) often involves trachea. In such patients, the trachea needs to be reconstructed after surgery. We discuss the postoperative outcome and complications after trachea reconstruction by free myocutaneous flap (FMF) and pedicled myocutaneous flap (PMF).From January 2009 to September 2019, the clinical data of 38 patients with TC were retrospectively analyzed. Demographics, pathologic results, neoplasm staging, surgical protocol, decannulation, subjective speech function, and complications were documented.A total of 38 patients were analyzed (22 FMFs and 16 PMFs). Of the 38 patients, there is a similar rate of decannulation (81.8% in FMF and 75% in PMF), subjective speech function and complications.The FMF reconstruction and the PMF reconstruction have a similar result in terms of postoperative outcome and complications.


Asunto(s)
Carcinoma/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos , Neoplasias de la Tiroides/cirugía , Tráquea/cirugía , Adulto , Anciano , Femenino , Colgajos Tisulares Libres , Humanos , Masculino , Persona de Mediana Edad , Colgajo Miocutáneo , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
10.
Khirurgiia (Mosk) ; (1): 5-14, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33395506

RESUMEN

OBJECTIVE: To analyze the long-term postoperative outcomes in patients with cicatricial tracheal stenosis and to determine the indications for various surgical strategies. MATERIAL AND METHODS: There were 976 patients with benign cicatricial tracheal stenosis for the period 2001-2017. Tracheal stenosis occurred after mechanical ventilation and tracheostomy in 910 (93.2%) patients. Other causes were neck trauma, burns, previous surgery or tuberculosis. Idiopathic stenosis was observed in 41 (4.2%) patients. Multiple-stage reconstructive treatment was possible due to benign nature of disease. There were 2.4 operations per a patient, and 976 patients underwent 2327 procedures. Circular tracheal resection was preferred (n=396). RESULTS: Surgical complications occurred in 107 (4.6%) cases, mortality rate - 0.3%. In long-term period, 42 patients died for various causes. In most cases (n=34, 80.9%), mortality was associated with concomitant diseases or consequences of trauma rather cicatricial tracheal stenosis or its treatment. Eight patients died from cicatricial tracheal stenosis or its treatment (7 patients after staged repair, 1 after circular tracheal resection). Four patients died due to asphyxia following T-tube obturation with a tracheobronchial secret or unjustified decannulation. For various reasons, 41 (6.2%) patients continued their treatment in other hospitals (4 patients died). Mortality rate in this group was 9.8%. Favorable long-term outcome was observed in 90.1% of patients, good and unsatisfactory results - in 7.2% and 1.8% of patients, respectively. Circular tracheal resection ensured better functional outcome. CONCLUSION: Surgical treatment of cicatricial tracheal stenosis is associated with low incidence of postoperative complications and mortality. However, further improvement in long-term results is associated with advanced rehabilitation programs for concomitant diseases. Treatment of cicatricial tracheal stenosis should be carried out at specialized hospitals.


Asunto(s)
Cicatriz/cirugía , Procedimientos Quirúrgicos Reconstructivos , Estenosis Traqueal , Cicatriz/etiología , Constricción Patológica/etiología , Constricción Patológica/cirugía , Humanos , Procedimientos Quirúrgicos Reconstructivos/métodos , Tráquea/cirugía , Estenosis Traqueal/diagnóstico , Estenosis Traqueal/etiología , Estenosis Traqueal/cirugía , Traqueostomía/efectos adversos , Resultado del Tratamiento
11.
J Laryngol Otol ; 135(1): 57-63, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33487190

RESUMEN

OBJECTIVE: The incidence of recurrent stenosis after cricotracheal resection is 3-9.5 per cent. Management of such patients is challenging. This study aimed to review our experience in revision cricotracheal resection. METHODS: The study was conducted in the Otorhinolaryngology Department, Mansoura University Hospitals, Egypt, on nine patients with recurrent stenosis following cricotracheal resection. Revision cricotracheal resection was performed in all patients. Surgiflo was applied on the site of anastomosis to enhance healing. RESULTS: No intra-operative complications were recorded. Minor post-operative complications occurred in two patients (surgical emphysema and temporary choking); no major complications were reported. Re-stenosis occurred in one patient. Successful decannulation was achieved in eight of the nine patients. CONCLUSION: Revision cricotracheal resection is the definitive curative treatment for recurrent stenosis after previous unsuccessful resection. It has high success rates, provided that careful pre-operative assessment and meticulous operative technique are performed.


Asunto(s)
Cartílago Cricoides/cirugía , Tráquea/cirugía , Estenosis Traqueal/cirugía , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Recurrencia , Reoperación , Estudios Retrospectivos , Adulto Joven
12.
J Thorac Cardiovasc Surg ; 161(3): 1112-1121.e7, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33419543

RESUMEN

OBJECTIVES: Airway anomalies are common in children with cardiac disease but with an unquantified impact on outcomes. We sought to define the association between airway anomalies and tracheal surgery with cardiac surgery outcomes using the Society of Thoracic Surgery Congenital Heart Surgery Database. METHODS: Index cardiac operations in children aged less than 18 years (January 2010 to September 2018) were identified from the Society of Thoracic Surgery Congenital Heart Surgery Database. Patients were divided on the basis of reported diagnosis of an airway anomaly and subdivided on the basis of tracheal lesion and tracheal surgery. Multivariable analysis evaluated associations between airway disease and outcomes controlling for covariates from the Society of Thoracic Surgery Congenital Heart Surgery Database Mortality Risk Model. RESULTS: Of 198,674 index cardiovascular operations, 6861 (3.4%) were performed in patients with airway anomalies, including 428 patients (0.2%) who also underwent tracheal operations during the same hospitalization. Patients with airway anomalies underwent more complex cardiac operations (45% vs 36% Society of Thoracic Surgeons/European Association for Cardiothoracic Surgery Congenital Heart Surgery Mortality category ≥3 procedures) and had a higher prevalence of preoperative risk factors (73% vs 39%; both P < .001). In multivariable analysis, patients with airway anomalies had increased odds of major morbidity and tracheostomy (P < .001). Operative mortality was also increased in patients with airway anomalies, except those with malacia. Tracheal surgery within the same hospitalization increased the odds of operative mortality (adjusted odds ratio, 3.9; P < .0001), major morbidity (adjusted odds ratio, 3.7; P < .0001), and tracheostomy (adjusted odds ratio, 16.7; P < .0001). CONCLUSIONS: Patients undergoing cardiac surgery and tracheal surgery are at significantly higher risk of morbidity and mortality than patients receiving cardiac surgery alone. Most of those with unoperated airway anomalies have higher morbidity and mortality, which makes it an important preoperative consideration.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos/mortalidad , Cardiopatías Congénitas/cirugía , Anomalías del Sistema Respiratorio/cirugía , Procedimientos Quirúrgicos Torácicos/mortalidad , Tráquea/cirugía , Adolescente , Factores de Edad , Canadá , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Niño , Preescolar , Bases de Datos Factuales , Femenino , Cardiopatías Congénitas/diagnóstico por imagen , Cardiopatías Congénitas/mortalidad , Humanos , Lactante , Masculino , Anomalías del Sistema Respiratorio/diagnóstico por imagen , Anomalías del Sistema Respiratorio/mortalidad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Procedimientos Quirúrgicos Torácicos/efectos adversos , Factores de Tiempo , Tráquea/anomalías , Tráquea/diagnóstico por imagen , Resultado del Tratamiento , Estados Unidos
14.
Acta Cir Bras ; 35(11): e351104, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33331454

RESUMEN

PURPOSE: To develop a simpler animal model for benign tracheal stenosis and introduce a low-cost household endoscope for postmodeling endotracheal evaluation. METHODS: Twenty rabbits were randomly divided into a model group (15 rabbits, subjected to transoral nylon brush scraping of the trachea) and a mock group (5 rabbits, merely exempted from scraping), a household endoscope was then introduced for weekly endoscopic examination. Meanwhile, other 15 rabbits (modeling like the model group) underwent batch tracheal resection at different postintervention times for pathological analysis. RESULTS: The model group presented a low mortality and few complications. The endoscope could obtain adequate images for stenosis assessment, which showed that the models presented homogeneous injury after scraping and developed a mature scar stricture at 28 days postoperatively with a mean stenosis degree of 65.9%, and 71.4% (10/14) above Myer-Cotton's grade II. The pathological findings were consistent with the clinicopathological process of human. No stenosis was found in mock group. CONCLUSION: The modified model is simpler, minimally invasive and reliable, while the household endoscope is competent for model's follow-up, providing easily accessible and useful tools for facilitating more extensive studies of benign tracheal stenosis.


Asunto(s)
Estenosis Traqueal , Animales , Modelos Animales de Enfermedad , Endoscopios , Endoscopía , Conejos , Tráquea/cirugía , Estenosis Traqueal/cirugía
15.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-33318283

RESUMEN

Subglottic stenosis is a disease that causes dyspnoea by congenital or acquired stenosis of the cricoid cartilage and trachea. The cause of acquired subglottic stenosis varies. In this case, we present a case of idiopathic subglottic stenosis. Tracheotomies are performed in many cases, but they require long-term insertion of a tracheal cannula and make treatment difficult. In this case study, we performed a tracheoplasty by resection of the arch of cricoid cartilage and circumcision of the tracheal cartilage and implemented a cannula-free observation protocol.


Asunto(s)
Cartílago Cricoides/cirugía , Laringoestenosis/cirugía , Tráquea/cirugía , Estenosis Traqueal/cirugía , Anastomosis Quirúrgica/métodos , Femenino , Humanos , Persona de Mediana Edad , Procedimientos Quirúrgicos Reconstructivos/métodos , Tomografía Computarizada por Rayos X
16.
J Laryngol Otol ; 134(6): 481-486, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32616097

RESUMEN

BACKGROUND: Advances in endoscopic technology have allowed transnasal oesophagoscopy to be used for a variety of diagnostic and therapeutic procedures. METHOD: A review of the literature was carried out to look into the extended role of transnasal oesophagoscopy within otolaryngology, using the Embase, Cinahl and Medline databases. RESULTS: There were 16 studies showing that transnasal oesophagoscopy is safe and cost effective and can be used for removal of foreign bodies, tracheoesophageal puncture, laser laryngeal surgery and balloon dilatation. CONCLUSION: This study presents a summary of the literature showing that transnasal oesophagoscopy can be used as a safe and cost-effective alternative or adjunct to traditional rigid endoscopes for therapeutic procedures.


Asunto(s)
Esofagoscopía/métodos , Nariz/cirugía , Otolaringología/normas , Análisis Costo-Beneficio , Dilatación/instrumentación , Esofagoscopía/efectos adversos , Esófago/cirugía , Cuerpos Extraños/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Laringe/cirugía , Terapia por Láser/instrumentación , Otolaringología/estadística & datos numéricos , Punciones , Seguridad , Tráquea/cirugía
17.
Khirurgiia (Mosk) ; (5): 96-99, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32500697

RESUMEN

A rare clinical observation of primary tracheal MALT lymphoma is reported and difficulties of differential diagnosis are discussed. Tracheal neoplasms are rare tumors and characterized by delayed diagnosis after clinical manifestation (tracheal stenosis and associated complications). These tumors often occur an advanced age patients that complicates examination and surgical treatment. High risk is determined by type of surgery, possible postoperative complications and senile age.


Asunto(s)
Linfoma de Células B de la Zona Marginal/cirugía , Neoplasias de la Tráquea/cirugía , Estenosis Traqueal/cirugía , Anciano de 80 o más Años , Diagnóstico Tardío , Humanos , Linfoma de Células B de la Zona Marginal/complicaciones , Linfoma de Células B de la Zona Marginal/diagnóstico , Tráquea/cirugía , Neoplasias de la Tráquea/complicaciones , Neoplasias de la Tráquea/diagnóstico , Estenosis Traqueal/diagnóstico , Estenosis Traqueal/etiología
18.
Khirurgiia (Mosk) ; (6): 18-23, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32573527

RESUMEN

OBJECTIVE: To analyze contamination of surgical wound during tracheal resection depending on the mode of mechanical ventilation. MATERIAL AND METHODS: There were 976 patients. Circular tracheal resection was made in 396 of these patients. RESULTS: Overall postoperative morbidity was 15.7%, mortality - 0.8%. Bacteriological examination of surgical wound was performed before tracheotomy and after formation of anastomosis depending on the method of mechanical ventilation. Surgical field was sterile before tracheotomy in all cases, contamination was confirmed after tracheotomy in all patients. Minimal contamination was observed in case of apneic oxygenation (100 times less than volumetric mechanical ventilation or high frequency mechanical ventilation). In all cases, several species of pathogenic microorganisms were identified. The number of species was also minimal in case of hypnotic mechanical ventilation. CONCLUSION: Contamination does not directly affect the development of local purulent-inflammatory process. However, this factor should not be ignored and compliance with all preventive measures is required.


Asunto(s)
Respiración Artificial/efectos adversos , Infección de la Herida Quirúrgica/microbiología , Herida Quirúrgica/microbiología , Tráquea/cirugía , Enfermedades de la Tráquea/cirugía , Traqueotomía/efectos adversos , Anastomosis Quirúrgica , Humanos , Respiración Artificial/métodos , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/etiología , Tráquea/microbiología , Enfermedades de la Tráquea/microbiología , Estenosis Traqueal/microbiología , Estenosis Traqueal/cirugía , Traqueotomía/métodos
19.
J Cardiothorac Surg ; 15(1): 130, 2020 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-32517719

RESUMEN

BACKGROUND: Salvage surgery has been frequently performed, increasing the opportunity to actively perform surgery for recurrence after a function-preserving operation. However, re-operation after airway reconstruction surgery on the proximal side and the effect of prior treatment, such as radiotherapy and/or chemotherapy, make the operation more difficult. In addition, cases of sleeve pneumonectomy after sleeve lobectomy with bronchoplasty are uncommon. CASE PRESENTATION: A 71-year-old lung cancer patient underwent right upper sleeve lobectomy with bronchoplasty combined with perioperative chemotherapy in 2007. A new undiagnosed right hilar mass that appeared 9 years post-operation showed a temporary response to radiotherapy but progressed thereafter. Sleeve pneumonectomy was completed 14 months after radiotherapy by the following procedures: dividing the right pulmonary artery at the proximal site under median sternotomy and then reconstructing the bronchus by telescoping the left main bronchus into the distal trachea after pneumonectomy under posterolateral thoracotomy. CONCLUSIONS: Sleeve pneumonectomy for recurrent lung cancer could be safely performed under good vision using a two-stage approach as salvage surgery, even in high-risk patients who received various treatments and proximal airway reconstruction.


Asunto(s)
Bronquios/cirugía , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Neoplasias Pulmonares/cirugía , Recurrencia Local de Neoplasia/cirugía , Neumonectomía , Anciano , Bronquios/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Recurrencia Local de Neoplasia/diagnóstico por imagen , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Procedimientos Quirúrgicos Reconstructivos , Terapia Recuperativa , Tráquea/diagnóstico por imagen , Tráquea/cirugía
20.
Pediatr Cardiol ; 41(7): 1376-1385, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32494877

RESUMEN

We performed this meta-analysis to assess the safety and efficacy of tracheoplasty for patients with pulmonary artery sling (PAS) and tracheal stenosis. Published studies that included surgical treatment of PAS and tracheal stenosis with and without tracheoplasty were identified by searching the PubMed, EMBASE, and Cochrane Library databases until May 2020. The outcomes assessed included postoperative ventilation time, early and late mortality, and follow-up respiratory symptoms. The mean difference (MD)/risk ratio (RR) with 95% confidence intervals (CI) was estimated with a random-effects/fixed-effects model. Subgroup analysis was performed stratified by percentage of patients with tracheal rings. A total of eight studies comprising 219 patients with PAS accompanied by tracheal stenosis were included. The pooled estimates of postoperative ventilation time (MD 17.68, 95% CI 6.38 to 28.98, p < 0.01) and early mortality (RR 3.93, 95% CI 1.55 to 9.95, p < 0.01) favored the repair-only group. Late mortality (RR 1.33, 95% CI 0.48 to 3.68, p = 0.58) and respiratory symptoms (RR 1.51, 95% CI 0.50 to 4.57, p = 0.47) at follow-up showed no significant differences between the groups with repair-only and repair with tracheoplasty. The same results were found in subgroup analyses. For the surgical treatment of PAS with tracheal stenosis, repair without tracheoplasty appears to result in shorter postoperative ventilation time and lower early mortality, with no increase in late mortality or respiratory symptoms at follow-up, compared with concomitant tracheoplasty.


Asunto(s)
Cardiopatías Congénitas/cirugía , Arteria Pulmonar/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Tráquea/cirugía , Estenosis Traqueal/cirugía , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Oportunidad Relativa , Arteria Pulmonar/anomalías , Procedimientos Quirúrgicos Reconstructivos/efectos adversos , Respiración Artificial , Resultado del Tratamiento
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