Circumferential tracheal resection to end anastomosis

1. Localized tracheal tumors. The length of the cut is generally not more than 6 cm. 2. The trachea is more than moderately narrow, and the narrow section generally does not exceed 4cm. Treatment of diseases: tracheal tumors Indication 1. Localized tracheal tumors. The length of the cut is generally not more than 6 cm. 2. The trachea is more than moderately narrow, and the narrow section generally does not exceed 4cm. Preoperative preparation 1. Fiberoptic bronchoscopy to determine the location and nature of the lesion. 2. bacteria culture plus drug sensitivity test, select effective antibiotics. 3. Train the patient's anterior cervical flexion to effectively cough and eat. Surgical procedure 1. Incision: cervical tracheal resection, the use of transverse neck incision, aortic arch upper thoracic tracheal resection, with the neck transverse incision plus the upper sternum cleft, tracheal resection below the upper edge of the aortic arch, right chest posterior lateral incision should be performed. 2. After the trachea is fully exposed, explore the location, adjacent relationship, and external invasion of the tracheal tumor. If the lesion can be removed, the thick wire is pulled at a distance of 1 cm at both ends of the tracheal resection plane. The trachea was cut off at a distance of 0.5 cm from the lower edge of the tumor. The distal trachea was then inserted into a tracheal intubation with appropriate caliber, and the anesthesiologist controlled the breathing. 3. Cut the trachea 0.5 cm from the upper edge of the tumor and remove the lesion. The two ends of the trachea were intermittently anastomosed and the lumen was externally ligated. It is required to suture the poorly exposed side of the tracheal wall. For example, if the neck is incision, the posterior wall of the trachea is first anastomosed, and the chest incision is firstly anastomosed. 4. Remove the tracheal intubation in the surgical field, insert the original oral tracheal intubation into the distal trachea over the anastomosis, and complete the tracheal anastomosis. The anastomosis can be covered with a pleural or pericardial flap. 5. The thick thread will suspend the mandible and the chest skin to ensure the position of the neck flexion 15 ° ~ 30 °.