Jan 1, 1995

Reconstructive airway operation after irradiation

The Annals of Thoracic Surgery
D D MuehrckeD J Mathisen

Abstract

After a patient died of anastomotic necrosis following a tracheal resection for the management of recurrent thyroid cancer invading the trachea, which had been treated 6 years previously by thyroid lobectomy and 4,800 cGy of radiation to control known residual disease, we explored methods to promote the healing of tissues damaged by irradiation. Between 1979 and 1992, 22 patients underwent major airway resection and reconstruction after receiving large doses of radiation. The average dose was 4,979 +/- 1,113 cGy (range, 3,150 to 6,840 cGy); the number of fractions, 20 to 38; and the average dose per fraction, 180 cGy (range, 150 to 200 cGy). The interval between irradiation and surgical treatment was 42 +/- 105 months (range, 1 to 480 months). Seven cervical, eight midtracheal, and five carinal resections were performed, as well as two mainstem sleeve resections. Omentum was used to protect the anastomosis in 15 patients (68%), a pericardial fat pad was used in 2, and pleura was used in 2. In 3 patients, sternohyoid muscle was placed between the anastomosis and a major vascular structure, but without a tissue wrap. Two patients (9.0%) died postoperatively. Anastomotic dehiscence was the cause of death in a patient treated for l...Continue Reading

  • References10
  • Citations28

References

  • References10
  • Citations28

Citations

Mentioned in this Paper

Neoplasm of Uncertain or Unknown Behavior of Pleura
Anastomosis, Surgical
Necrosis
Anatomical Anastomosis
Blood Vessel
Trachea
Myocardial Infarction
Reproductive Dehiscence
Radiotherapy, Targeted
Malignant Tumor of Pleura

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