Circular resection of the trachea for cicatricial stenosis

Abstract

The primary interventions for trachea in the thoracic surgery units are performed for the treatment of cicatricial stenosis of the trachea. Circular resection of the trachea is one of the treatment procedures in this pathology. The benefit of this method as compared to the others is that the resection with tracheo-tracheal anastomosis allows a one-stage recovery of patient with this pathology. The first successful resection of the trachea was performed in the late 19th century, and since then this surgery technique is constantly being improved. Several methods of suture placing in anastomosis surgery are proposed, different suture materials are used, special devices are developed to facilitate the anastomosis performing. There are several tactics depending on the presence or absence of tracheostome in the patient. Different methods are worked out to approximate the trachea ends with different diameters. Prevention of anastomosis leakage is achieved by strengthening the anastomosis area to reduce the suture tension. In addition, there are studies dealing with the improvement of trachea regeneration by physiotherapy impact on the anastomosis area. Laser therapy and hyperbaric oxygenation are also put forward for use. Nevertheless, a number of items remain to be solved: indications for circular resection of the trachea are not clearly formulated, the size of trachea fragment to be resect is the subject of active discussion.

Keywords

• cicatricial stenosis of the trachea
• circular resection
• anastomosis