A Reverse Thymic Fat Pad Flap to Cover the Anastomosis of an Extended Tracheal Resection Following Induction Chemotherapy: A Challenging Case Report

Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to prot...

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Bibliographic Details
Published in:Surgeries 2022-09, Vol.3 (3), p.271-276
Main Authors: Mastromarino, Maria Giovanna, Cardillo, Giuseppe, Jaus, Massimo Osvaldo
Format: Article
Language:English
Subjects:
extended tracheal resection
induction chemotherapy
thymic fat flap
tracheal cancer
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Summary:Extended tracheal resection after neoadjuvant chemotherapy is rarely described in patients with tracheal cancer. Controversies still exist among surgeons about the length of tracheal resectability and possible harmful anastomotic complications. Different vascularized tissue flaps can be used to protect the anastomotic suture line. We reported a 67-year-old patient with middle tracheal squamous cell carcinoma treated by induction chemotherapy followed by a successful extended tracheal resection. The anastomosis was covered by a reversed thymic fat pad flap to prevent the erosion of adjacent brachiocephalic vessels. Postoperative concurrent chemoradiation did not threaten the integrity of the suture line. Careful tracheal dissection and accurate release manoeuvres are mandatory to achieve a tension-limited anastomosis. Extended tracheal resection may be safely performed after induction chemotherapy, with excellent long-term outcomes. A thymic fat flap seems to be beneficial to suture-line healing.
ISSN:2673-4095
2673-4095
DOI:10.3390/surgeries3030029