Author/Authors :
Hashemzadeh, S Department of Thoracic Surgery - School of Medicine - Tabriz University of Medical Sciences , Banazadeh, M Department of Thoracic Surgery - School of Medicine - Tehran University of Medical Sciences , Kakaei, F Department of General Surgery - School of Medicine - Tabriz University of Medical Sciences
Abstract :
Mediastinal tracheostomy is a complex surgical procedure for the management of airway
reconstruction in patients whose distal trachea is not sufficiently long to be reconstructed as cervical
tracheostomy after tracheal resection for malignant diseases. In this article (study), we present our 10
year experience of this uncommon procedure in thoracic surgery ward of Imam Khomeini's Hospital,
Tehran. Sixteen patients (87.5% male, 12.5% female, 58.4±1.4 y/o) underwent this procedure because
of thyroid cancer (31.3%), SCC of cervical trachea (12.5%), postcricoid esophageal cancer (12.5%),
and laryngeal cancer (43.8%). The procedure was associated with cervical exenteration in 12.5% and
total laryngectomy (44%), thyroidectomy (6.2%), laryngopharyngoesophagectomy (12.5%), resection
of neck mass (18.5%) and repair of cervical esophageal fistula with myocutaneous flap (6.2%).They
had history of total thyroidectomy (25%), total laryngectomy (25%), cervical tracheostomy (13%), and
hemi-laryngectomy (6%). Six percent of patients died because of uncontrolled intraoperative
hemorrhage, and 94% were complicated with postoperative hypocalcemia (31%), osteomyelitis (13%),
fistula (13%) and necrosis of the flap (13%).
Keywords :
Mediastinum , tracheal surgery , esophageal surgery , tracheostomy technique
