State of the art in tracheal surgery: a brief literature review

Mohsen Ibrahim,Erino Angelo Rendina,Alessandra Siciliani

doi:10.4081/mrm.2018.182

Mohsen Ibrahim, Erino Angelo Rendina + Show 1 more

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https://doi.org/10.4081/mrm.2018.182

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Abstract

Background: Tracheal surgery requires a highly specialized team of anesthesiologists, thoracic surgeons, and operative support staff. It remain a formidable challenge for surgeons due to the criticality connected to anatomical considerations, intraoperative airway management, technical complexity of reconstruction, and the potential postoperative morbidity and mortality. Main body: This article focuses on the main technical aspects and literature data regarding laryngotracheal and tracheal resection and reconstruction. Particular attention will be paied to anastomotic and non-anastomotic complications. Short conclusion: Results from literature confirm that, when feasible, laryngotracheal and tracheal resection and reconstruction is the treatment of choice in cases of benign stricture and malign neoplasm. Careful patient selection, operative planning, and execution are required for optimal results.

Highlights

Interventional pulmonology treatments, such as mechanical dilatation, laser ablation and stenting have a limited and transient role in the treatment of tracheal lesions due to frequent recurrences
In 1950, Barclay described the first tracheal resection [1]. It was only in 1990 that Grillo demonstrated the feasibility of surgical treatment of tracheal stenosis for the first time and later, surgery for any type of tracheal disease requiring resection, including tumors, by resection of a portion of the trachea and its reconstruction by primary reanastomosis [2, 3]
Resection and reconstruction techniques based on the site of lesions In LTRR, when the disease involves the subglottic region near the vocal cords, there are many technical problems due to the necessity of extending the resection to the cricoid cartilage and the high risk of damaging both of the recurrent laryngeal nerves as experienced by Ogura and Powers in 1964 [21]

Summary

Background

The first tracheal surgical procedures described date back to the second and third century with the reports of Aretaeus and Galen on tracheostomy. Despite this ancient acknowledgment, modern tracheal surgery developed much later. In 1950, Barclay described the first tracheal resection [1] It was only in 1990 that Grillo demonstrated the feasibility of surgical treatment of tracheal stenosis for the first time and later, surgery for any type of tracheal disease requiring resection, including tumors, by resection of a portion of the trachea and its reconstruction by primary reanastomosis [2, 3]. Laryngotracheal (LTRR) and tracheal resection and reconstruction (TRR) will be discussed in this article

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