Postoperative management and complications at end-to-end anastomosis of the trachea

Abstract

We report two cases of head and neck cancer invading the trachea. Tumor resection and end-toend anastomosis were performed at the same time. One case was a thyroid papillary carcinoma, and the other was metastasis of a paratracheal node that invaded the thyroid, trachea and esophagus. Both patients required long-term intubation because of obstruction of the airway due to laryngeal edema and a tracheostomy was necessary. We can infer from these cases that the causes of severe vocal edema were infection, history of radiotherapy and extensive resection. In addition, it is quite likely that one of the causes of airway obstruction was recurrent laryngeal nerve palsy. Long-term intubation may be considered a cause of laryngeal edema and recurrent nerve palsy. Because it is difficult to estimate the risk of vocal edema, and difficult to know how long intubation will be required, we have to carefully consider the complications related to such procedures.