Tracheal Tumors - Resections and Palliative Care

Abstract

Aim: The primary malignant neoplasms of the trachea and tracheal invasion of cancer, although rare, are serious causes of morbidity and mortality. The treatment of tracheal tumors generally includes interventional endoscopy, surgery, radiation therapy and palliative methods. We present 8-year experience in the treatment of tumors of the trachea, advanced tracheal resections, reconstruction and palliative endoscopic procedures /laser desobstruction, endoscopic balloon dilatation and stenting/.Materials and Methods: This was a prospective study over 8 years. 12 patients with resection and plastic trachea of a tracheal tumor aged 36 to 68 years were operated on. Proximal tracheal resection was performed in 4 patients and distal - in 8. The average length of resected trachea was 3.5 cm (3 to 5.5 cm). There were 46 endoscopic procedures and 14 stents were placed in unresectable patients.Results: Patients were followed up after the procedures. All patients with resection and plasty of the trachea were still alive at the end of the studied period. There was no perioperative mortality. We have established adenocarcinoma in 3 patients, squamous cell carcinoma -3 patients, typical carcinoid tumors - in 4 patients, thyroid carcinoma - in 2 patients. All patients with malignancies underwent chemo- and radiotherapy. 6 patients with tracheoesophageal fistula after radiotherapy were observed among patients with stents. The life expectancy of patients with stents is from 6 days to 16 months. Conclusions: Тracheal resection is the treatment of choice for tracheal tumors. It is a safe procedure with a very good oncological outcome. Perfect surgical technique is mandatory to avoid tension on the anastomosis and maintain blood flow to the trachea. Palliative methods are required in unresectable patients. In patients with stents, it helps to avoid imposing additional events in the development of tracheoesophageal fistula after radiotherapy.