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J Thorac Cardiovasc Surg 2005;129:1455-1456
© 2005 The American Association for Thoracic Surgery
Brief Communication |
a Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy
b Head and Neck Division, European Institute of Oncology, Milan, Italy
c Division of Anesthesiology and Intensive Care Unit, European Institute of Oncology, Milan, Italy
Received for publication October 2, 2004; accepted for publication November 4, 2004. * Address for reprints: Lorenzo Spaggiari, MD, PhD, Division of Thoracic Surgery, European Institute of Oncology, Via Ripamonti, 435, 20141 Milan, Italy (Email: lorenzo.spaggiari@ieo.it).
| The first 20% of the full text of this article appears below. |
Tracheal resection is still one of the greatest challenges in the treatment of tracheal tumors.1 The maximum amount of trachea that can be resected during resection-anastomosis is around 50%, but, when a larger resection is required, the risk of postoperative dehiscence increases, followed by a very elevated risk of postoperative death.
We report on our experience with treating a tracheal anastomotic dehiscence that developed after an extended tracheal resection was performed for a thyroid tumor relapse. The technique used to repair the dehiscence, a composite skin/omental/muscle graft, permitted restoration of tracheal continuity and of a normal respiratory function.
Clinical Summary
In May 2001, a 37-year-old man underwent thyroidectomy for medullary carcinoma of the thyroid at another institution. In May 2002, he developed a relapse with tracheal infiltration and was admitted to our institute in July 2002 for an extended resection of the trachea. A double transmanubrial approach was used.2 After an extensive tracheal devascularization, a 5.5-cm long tracheal resection was performed. The tumor (9.2 cm
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