Two cases of anterior mediastinal tracheostomy

Abstract

We report the importance of anterior mediastinal tracheostomy with pectoralis major myocutaneous and fascio-cutaneous flaps in 2 advanced cancer cases. The first case is a 59-year-old male with cervico-thoracic esophageal cancer (squamous cell carcinoma). The patient recieved pharyngo-laryngectomy, total esophagectomy with neck and anterior mediastinal dissection after thoracotomy. The second case is a 53-year-old male with bronchogenic cancer (adenocarcinoma). The patient recieved pharyngo-laryngo-cervical esophagectomy with neck and anterior mediastinal dissection after thoracotomy. One of the problems of anterior mediastinal surgery is fatal hemorrhage due to a rupture of the innomiate artery. To avoid undue tention at the tracheal cutaneous suture line and to keep sufficient blood supply to the tracheal stump are important. We used pectoralis major myocutaneous and fascio-cutaneous flaps in anterior mediastinal tracheostomy as rotation flaps. We consider this fascio-cutaneous flap to be easy to make and safe to use in these kinds of patients.