Tracheal Tumor Resection Research Articles

A case of thoracoscopic-assisted tracheal tumor resection and tracheal reconstruction

Primary tracheal tumor is a disease with low morbidity and poor prognosis. Surgical resection is the main treatment. It is difficult to treat tracheal tumors, while involving tracheal reconstruction operations are more complicated. We report a case of tracheal tumor patient. The large tumor was located above the tracheal carina and the opening of the left main bronchus. The lumen of the left main bronchus was significantly narrowed. The patient was received thoracoscopic-assisted tracheal tumor resection and tracheal reconstruction under general anesthesia. The patient recovered healthy after operation without serious complications. Thoracoscopic-assisted tracheal tumor resection provides a flexible surgical option for the treatment of this disease.

Case Report: ECMO-Assisted Uniportal Thoracoscopic Tracheal Tumor Resection and Tracheoplasty: A New Breakthrough Method

Primary tracheal tumors are seldom seen, and most of them are malignant. At present, the main treatment is surgical resection. It is rare to accomplish tracheal tumor resection and tracheoplasty via uniportalal thoracoscopy. In order both to maintain the patient's oxygen supply during surgery and to reduce the size of the surgical incision, we have innovatively integrated the ECMO-assisted and uniportal thoracoscopic techniques for the first time, perfectly achieving tracheal tumor resection and tracheoplasty. The intraoperative manipulation was only 180 min in duration. The patient returned to the intensive care unit and recovered smoothly after the surgery. The patient was discharged from the hospital 17 days after the operation. ECMO-assisted uniportal thoracoscopic tracheal resection and tracheoplasty provides a new idea and method for colleagues.

Veno-venous extracorporeal membrane oxygenation used as an adjunct in the surgical management of acquired and iatrogenic tracheobronchial pathology.

Surgical repair of tracheobronchial tree injuries is challenging due to the difficulties associated with providing perioperative ventilatory support. Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a recognized treatment modality for managing respiratory failure. Its use has expanded to include offering respiratory support for patients requiring surgery on the tracheobronchial tree. This study presents our experience with V-V ECMO support for elective and emergency surgery for acquired and iatrogenic tracheobronchial pathology. A retrospective review of our single-center experience of surgical tracheobronchial repairs where V-V ECMO was employed between 2017 and 2020 was undertaken. Preoperative patient characteristics, intraoperative findings, details of ECMO support and postoperative outcomes were collected and analyzed. Five patients underwent surgery with V-V ECMO support during the study period. Indications for surgery included repair of iatrogenic tracheal tear (N.=2), repair of iatrogenic gastro-bronchial fistula (N.=1), elective tracheoplasty (N.=1) and elective resection of tracheal tumor (N.=1). The median duration of V-V ECMO was 17 hours (range: 4-543 hours), and the median postoperative length of stay was 9 days (range: 7-19 days). In-hospital and 90-day mortality were both 0% (N.=0). Postoperative complications included reoperation for bleeding (N.=1) and thrombotic complications (N.=2). We have shown how V-V ECMO can be safely utilized to manage patients with a range of tracheobronchial injuries with low rates of postoperative morbidity. Acceptable postoperative outcomes can be achieved for this cohort of clinically complex patients when treatment is provided with a multidisciplinary team approach in high-volume specialist centers.

Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia

Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia

Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia: a case report

Video-assisted thoracoscopic tracheal tumor resection with acupuncture drug compound non-intubated anesthesia: a case report

Adenoid Cystic Carcinoma Invade the Tracheal Prominence: A Case Report and Literature Review

Background: Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thoracic diseases. Objective: To explore the epidemiology, diagnosis, treatment and future development of tracheal adenoid cystic carcinoma (TACC). Methods: With asymptomatic invasion of the tracheal prominence, a case of tracheal adenoid cystic carcinoma with asymptomatic invasion of the tracheal prominence was reported. The clinical management process and surgical methods were introduced, and related literature was reviewed and summarized. Results: The patient was admitted due to tracheal augmentation mass for half a month. Chest CT at admission displayed the soft tissue density shadow behind the tracheal augmentation process. After the completion of other examinations, tracheal tumor resection and tracheal reconstruction were performed. Postoperative routine pathology exhibited that it was TACC and without inguinal lymph node metastasis. Conclusion: TACC is a low-grade tracheal tumor with low incidence, delayed clinical manifestations and lack of specificity as well. CT and bronchoscopy are helpful for the diagnosis of suspected patients. Meanwhile, radical surgical resection is the first choice of treatment. Adjuvant therapy can improve the therapeutic effect. Targeted immunotherapy is the developing direction of treatment.

The anesthesia management of tracheal tumor resection combined with right pulmonary lobectomy under general anesthesia--A case report

The tracheal tumor is a challenge to anesthesiologists for anesthesia management. It is more difficult for anesthesia management for tracheal tumor resection and lobectomy on patients who carried tracheal tumor combined with pulmonary tumor. The basic principle of anesthesia is to ensure the patient′s ventilation and maintain the blood oxygen level. This kind of tracheal management has specialty. This case report is about the anesthesia management of a 66-year-old female patient who experienced the tracheal tumor resection and right pulmonary lobectomy under general anesthesia. We hope it will provide successful reference for the anesthesia management of such cases. Key words: Tracheal tumor; Pulmonary lobectomy; Anesthesia

Pulmonary Inflammatory Myofibroblastic Tumor: Surgical Resection and Long-Term Surveillance

Objective: Inflammatory myofibroblastic tumor is a very rare mesenchymal tumor, we share our experience of surgical treatment for inflammatory myofibroblastic tumor. Materials and Methods: From January 2005 to January 2015, 32 patients were recruited in this study including 13 males and 19 females who received surgery and diagnosed as inflammatory myofibroblastic tumor. Postoperative followup was conducted by thoracic surgeons every 3 months until 12 months after surgery, after that every 6 months until 24 months, and then yearly. Results: 32 patients (aged: 9-72 yr, average:37.85 ± 19.42 yr, 13 males and 19 females ) received surgical treatment for inflammatory myofibroblastic tumor (ranged:0.8-8 cm, average:3.84 ± 2.05 cm), including 15 cases of lobectomy, 7 cases of wedge resection, 4 cases of bronchoplasty, 2 case of tracheal tumor resection, 3 cases of sleeve resection and 1 case of wedge resection with biopsy of the chest wall. 31 patients are still alive till now, while one patient die 6 months after the surgery. Conclusion: It suggested that complete resection of the IMT lesions may lead to a promising long-term survival, otherwise it may lead to a compromised outcome.

Institution of cardiopulmonary bypass in an awake patient for resection of tracheal tumor causing near total luminal obstruction.

Institution of cardiopulmonary bypass in an awake patient for resection of tracheal tumor causing near total luminal obstruction.

Surgical treatment of primary tracheal tumors in 63 cases

To summarize the experience in diagnosis and treatment of primary tracheal tumors, and to improve the life quality of patients. Sixty-three patients with primary tracheal tumors treated in the First Affiliated Hospital of China Medical University during the past 40 years were included in this study, among them, there were 42 cases of malignant tumors and 21 cases of benign tumors. The 61 patients underwent surgery including tracheal sleeve resection (22), carinal resection and reconstruction (6), semi-carinal resection and reconstruction (6), tracheal resection for tracheal tumors (17); tracheostomy (4), tracheal resection, partial resection of the thyroid (goiter) and esophagomyotomy (1), tracheal tumor resection and vertical hemilaryngectomy with reconstruction of laryngeal ventricle and trachea by sternocleidomastoid flap (2), cervical trachea and laryngeal resection (1), and carinal scrape (2). Fifty-five patients had an uneventful recovery. Eight patients suffered from postoperative complications, among them 3 patients died postoperatively. Primary tracheal tumors often present atypical symptoms, are easily misdiagnosed and with poor prognosis. The main aim of treatment remains to remove the airway obstruction.

Surgical technique and results of tracheal and carinal replacement with aortic allografts for salivary gland–type carcinoma

We describe the surgical technique and peroperative management of tracheal and carinal replacement with aortic allografts for large salivary gland-type carcinoma and report the results with a mean 34 months' follow-up. We performed tracheal and carinal replacements with aortic allografts in 6 patients with extensive mucoepidermoid (n = 1) or adenoid cystic (n = 5) carcinomas. Tracheal tumor resection was followed by carinal restitution (n = 3) and interposition of the graft, splinted by a silicone stent. The allograft consisted of an aortic segment, either fresh (in the first 2 patients) or cryopreserved (in the last 4). All grafts were wrapped with bulky and well-vascularized flaps (pectoral muscle flap all patients, with an additional "thymopericardial fat flap" in the last 2) to promote revascularization and to prevent erosion of adjacent large vessels or fistulas. No immunosuppressive therapy was administered. Complete resection (R0) was achieved in 5 (83%) of 6 patients. Three of the first 4 patients experienced major morbidity, mainly fistulas between the esophagus and graft. The last 2 patients had an uneventful outcome. All grafts transformed into well-vascularized conduits focally lined with respiratory epithelium. So far, the last 4 patients are disease-free and 3 of them have returned to full-time employment. Stent removal has not been attempted in any patient. Tracheal replacement with aortic allografts enables resection of extensive tumors with a curative intent. Efficient protective wrap around the graft is mandatory. Further follow-up is required to determine whether cartilage rings are generated within the graft, as in animal models.

Tracheal replacement by autogenous aorta

BackgroundTracheal defects may occur after trauma or prolonged intubation. Resection of tracheal tumors also poses a major challenge for substitution. In an effort to solve this problem, different techniques have been tried with little success. We report on a new animal model which showed acceptable results with fewer complications.MethodsWe replaced 5 cm of cervical trachea in 10 dogs with harvested infra-renal aorta and repaired the aortic defect with Dacron graft.ResultsNecropsy of the grafted aorta and anastomotic site revealed well healed anastomosis in all animals together with ciliated columnar epithelium coverage of grafted aorta and neovascularization of aortic wall.ConclusionAortic graft is preferable to other substitutes because of less antigenicity, less vascularity, and no mucous secretions or peristalsis

Anesthetic management of a 9‐year‐old child undergoing resection of a tracheal tumor

Primary tracheal tumors in children are rare. We report the anesthetic management of a 9-year-old child undergoing resection of a midtracheal tumor obstructing approximately 73% of the tracheal lumen. To prepare for any possible airway emergency during the induction and maintenance of anesthesia, we ascertained preoperatively that a mini-tracheotomy tube could be inserted at the distal portion of the tracheal lesion. Oxygenation and ventilation were adequately maintained throughout the period of anesthesia. Anesthetic management for tracheal tumor resection should reflect the location of the tumor and the degree of tracheal obstruction.

Tracheal reconstruction with autogenous composite nasal septal graft

We describe lateral resection of tracheal tumors and repair of the defect with a composite graft of nasal septal mucosa and cartilage. The preliminary experience with this technique in 3 patients was satisfactory. The procedure can be used for patients who are not candidates for standard resection and end-to-end anastomosis.

Surgical Management of Tracheal Tumors

Resection of tracheal tumors is particularly challenging when the neoplasm involves the carina or is located in close proximity. We reviewed our experience with 22 tracheal resections for tumor. In this retrospective review, adenoid cystic carcinoma was diagnosed in 13 patients, squamous cell carcinoma in 5, typical carcinoid in 2, and leiomyoma and benign fibrous histiocytoma, in 1 each. There were 19 segmental resections with direct anastomosis, and 3 complex resections in which the carina was involved. One patient with tumor in the trachea and left main bronchus underwent resection through simultaneous bilateral thoracotomy and died. During 2 to 17 years of follow-up, 2 patients died of unrelated disease, 2 died of metastases, and 1 is receiving radiotherapy for recurrence. Sixteen patients are well and free of tumor. Complete resection of all neoplastic tissue is mandatory, but benign and low-grade malignant tumors should be resected conservatively with preservation of lung parenchyma. Options for treatment of neoplasms involving trachea and left bronchus should include resection of the neoplasm in two stages, thus minimizing trauma of each operation.