P-212REDO TRACHEAL SURGERY FOLLOWING PREVIOUS RESECTION

• Published in: Interactive cardiovascular and thoracic surgery 2013-07, Vol.17 (suppl_1), p.S55-S55
• Main Authors: Bolca, Ciprian, Dumitrescu, M., Danaila, O., Paleru, C., Cordos, I.
• Format: Article
• Language: English
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivt288.212

Objectives To present our experience with tracheal re-resection and reconstruction. Methods Between January 2007 and December 2010 we have performed redo tracheal surgery in eight patients. Re-resection was performed per primam in a patient with an adenoid cystic carcinoma recurrence 3 years after surgery and in five patients with anastomotic stenosis after initial resection for postintubation injury. Two more patients (with initial resection for postintubation stenosis) were initially dilated by means of rigid bronchoscopy. In addition a tracheal T-tube was used for a period of time before redo surgery. The range of the resected specimen length was 1.5 to 2.5 cm of trachea, so finally we had a total length of tracheal resection between 2.5 and 4 cm. Only pretracheal dissection (more difficult this time) and neck flexion were used as release maneouvres. All cases with initial postintubation stenosis were cervically situated and the approach was a simple cervicotomy; the tumoural reccurence required a partial sternotomy. In all cases we performed a circular tracheal re-resection; there was no subglotic laryngeal involvement. Results There were no perioperative deaths. After a follow-up between 3 and 6 years there were no stenotic recurrences. A good outcome with no physical limitations and a normal voice was achieved in 7 patients. Vocal cord dysfunction was seen in one patient. Conclusions Redo tracheal resection is safe in well chosen patients. Good results can be expected in experienced centres. Adenoid cystic carcinoma is well known for local reccurrence long term after initial surgery, so close follow-up must be done. Anastomotic tension and failing to initially resect all impaired tracheal tissue are the main causes of tracheal restenosis. Disclosure All authors have declared no conflicts of interest.