1/378. Emergency resection of distal tracheal stenosis. A case report.A case of tracheal stenosis secondary to tracheostomy and respirator treatment is presented. The stenosis caused acute respiratory failure, which made immediate surgical intervention mandatory. It is stressed that usually the tracheal lumen is severely reduced when the stenosis causes alarming symptoms. Rational treatment, which must be instituted immediately, consists of resection of the stenotic area and end-to-end anastomosis.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
2/378. Symptomatic tracheal stenosis in burns.tracheal stenosis in burns is rare and usually results from prolonged intubation or tracheostomy. inhalation injury itself has the potential risk of tracheal stenosis. We reviewed the records of 1878 burn patients during 1987 to 1995 and found seven with tracheal stenosis (0.37%) after an average of 4.4 years follow up. There were 4 males and 3 females with an average age of 27.3 years. The tracheal stenosis developed 1-22 months after burn (average 7 months). Five patients had their inhalation injury confirmed by bronchoscopic examination. The incidence of tracheal stenosis among inhalation injury patients was 5.49% (5/92). Six patients needed intubation in the initial stage either for respiratory distress or prophylaxis, with an average duration of 195.2 h. In addition to prolonged intubation, the presence of inhalation injury, repeated intubations and severe neck scar contractures are also contributors to tracheal stenosis in burns. We favor T-tube insertion as the first treatment choice; permanent tracheostomy was unsatisfactory in our study.- - - - - - - - - - ranking = 1.4285714285714keywords = stenosis (Clic here for more details about this article) |
3/378. Intrathoracic retroesophageal goiter causing tracheal stenosis.A 65-year-old woman presented with stridor revealed a mass on a chest X-ray on physical examination. A huge goiter arising in the left lobe of the thyroid had extended retroesophageally and across the midline to the right side of the posterior mediastinum far caudally down to the level of the carina. The trachea was remarkably compressed. Surgery was performed via a combined thoracic and cervical approach, and the tumor was completely removed with resultant relief from stridor. The patient is presently doing well at 1 year after the operation.- - - - - - - - - - ranking = 0.57142857142857keywords = stenosis (Clic here for more details about this article) |
4/378. Percutaneous dilation of tracheal stenosis.A high-grade complex tracheal stenosis distal to a tracheostomy tube occurred in a patient with a chronic vegetative state. The stenosis was easily and rapidly dilated at bedside using commercially available percutaneous tracheostomy kit dilators. Following tracheal dilation, a larger tracheostomy tube was inserted, resulting in the splinting of the stenotic area. To my knowledge, this is the first report of such a bedside technique for the dilation of a tracheal stenosis through a tracheostomy. This technique may provide a temporary relief from tracheal obstruction as long as the stenosis is within the reach of the dilator.- - - - - - - - - - ranking = 1.1428571428571keywords = stenosis (Clic here for more details about this article) |
5/378. A case of follicular thyroid cancer with tracheal stenosis responded to external radiation therapy.We report the case of a 70-year-old man with follicular carcinoma of the thyroid who complained of worsening dyspnea and was successfully treated by external radiation therapy. The total dose given was 61 Gy in 28 fractions. This case suggests that external radiation therapy is effective for the management of differentiated thyroid cancer with critical stenosis of the trachea that is inoperable and difficult to treat with radioiodine.- - - - - - - - - - ranking = 0.71428571428571keywords = stenosis (Clic here for more details about this article) |
6/378. Long-segment congenital tracheal stenosis: treatment by slide-tracheoplasty.BACKGROUND/PURPOSE: The prognosis of long-segment funnel-shaped congenital tracheal stenosis improved with surgical management by enlargement-tracheoplasty with a pericardial patch. However, the final outcome is not always satisfying mainly because of the complications related to the pericardial graft and because of misdiagnosed associated cardiovascular malformations. The objective of the report is to show a further improvement of the prognosis by a thorough preoperative planning and the use of a slide-tracheoplasty for the cure of the stenosis, to avoid the major drawbacks of enlargement tracheoplasties. methods: Two children, 7 months and 3 years old, underwent a bronchoesophagoscopy, spiral computed tomography, an echocardiogram, and a heart catheterization. The tracheal stenosis and the associated severe cardiovascular malformations were cured during a single operative session under cardiopulmonary bypass; the tracheal stenosis was corrected by a slide-tracheoplasty. RESULTS: The postoperative period was remarkably uneventful and the recovery extremely quick (hospital stay of 18 and 17 days). The midterm results are excellent, and the tracheal growth is not impaired (follow-up of 3 1/2 and 3 years). CONCLUSIONS: According to the authors' experience and to the literature, the slide-tracheoplasty seems to be the most efficient surgical procedure for correction of long-segment funnel-shaped congenital tracheal stenosis. But the success of the treatment depends also on a complete preoperative diagnosis allowing a 1-stage surgical treatment of all associated thoracic malformations.- - - - - - - - - - ranking = 1.2857142857143keywords = stenosis (Clic here for more details about this article) |
7/378. Intraoperative use of automated external defibrillator.We report on the anesthetic management of a patient with peripartum cardiomyopathy and frequent episodes of ventricular tachycardia, who underwent surgery for tracheal stenosis. Prior to this surgery, the patient had been implanted with an automatic implantable cardioverter-defibrillator (AICD), placed abdominally. In the operating room, the AICD was deactivated, and an automated external defibrillator (AED) was placed. Intraoperatively, the AED identified and treated the patient's ventricular tachycardia. Advantages of the AED in this hospital setting included rapid response to the cardiomyopathy, safe, hands-free operation, and minimal disruption of the surgical procedure. safety concerns when using the AED are also detailed.- - - - - - - - - - ranking = 0.14285714285714keywords = stenosis (Clic here for more details about this article) |
8/378. Surgical management of idiopathic tracheal stenosis.Most nonmalignant upper tracheal stenoses are caused by prolonged endotracheal intubation or tracheostomy, and idiopathic stenosis is uncommon. A 43-year-old woman complained of increasing shortness of breath during exercise over a year prior to admission. She had no significant past medical history, including endotracheal intubation. bronchoscopy and tracheal tomography revealed nonmalignant circumferential upper tracheal stenosis 20 mm long. Single-stage surgical resection with cricotracheal anastomosis completely relieved her respiratory symptoms. Idiopathic tracheal stenosis is extremely rare, and the treatment of choice is surgery.- - - - - - - - - - ranking = 1keywords = stenosis (Clic here for more details about this article) |
9/378. Tracheoplasty in a large tracheoesophageal fistula.Postintubation tracheoesophageal fistulas (TEFs) are severe lesions that can be associated with tracheal stenosis and therapeutic difficulties. A case is reported of a woman with TEF and postintubation tracheal stenosis with 6.5 cm of affected trachea, and total esophageal exclusion. A tracheoplasty method is described patching the loss of the tracheal membranous wall with the posterior esophageal wall. In a final step, a self-expanded tracheal stent and esophagocolic bypass were added.- - - - - - - - - - ranking = 0.28571428571429keywords = stenosis (Clic here for more details about this article) |
10/378. Postoperative airway stenosis and stent therapy in carinal reconstruction for lung cancer.A 48-year-old male had adenocarcinoma of the right upper lung lobe that invaded the lower trachea. The right upper lobe, the carina, and 5 rings of the lower trachea were resected. The carina was reconstructed using end-to-end anastomosis between the trachea and right intermediate bronchus, with the left main bronchus anastomosed to the side wall of the intermediate bronchus. Two months after surgery, the right intermediate bronchus developed bronchomalacia and the tracheal anastomosis granulatory stenosis. bronchomalacia was treated with 2 expandable metallic stents, and granulatory stenosis with a Dumon stent. Although the silicone stent successfully dilated the granulatory stenosis, the metallic stents caused delayed glanulatory stenosis. We concluded that a metallic stent is not desirable for treating postreconstructive airway stenosis including bronchomalacia, whereas a Dumon stent may be effective.- - - - - - - - - - ranking = 1.2857142857143keywords = stenosis (Clic here for more details about this article) |
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