Tracheal T-tube treatment following tracheoplasty--post-intubation tracheal obstruction and stenosis
Kimino, K.; Uchiyama, Y.; Yamaoka, N.; Akamine, S.; Matsuo, S.
Nihon Kyobu Geka Gakkai 38(12): 2460-2464
1990
ISSN/ISBN: 0369-4739 PMID: 2290062 Document Number: 359615
A 26-year-old man with post-intubation tracheal obstruction and stenosis was treated at our department. The lesions were granulomas, showing almost complete obstruction of the tracheal lumen at the stomal level, circumferential cuff stenosis at the cuff level and pressure necrosis on the trachea directly behind the brachiocephalic artery. Circumferential resection of the trachea including 13 tracheal cartilages with end to end tracheal anastomosis was performed. The site of the anastomosis was covered with pedicled omentum retrosternally. Seven days following the tracheal resection, a granulomatous lesion resulting in dyspnea was found at the distal trachea of the anastomosis. Subsequently, a tracheal T-tube was inserted, he had a remarkable improvement of the patient's overall condition. Pedicled omental wrapping of tracheal anastomotic site was found quite useful, particularly in the case of possible anastomotic insufficiency. Treatment of post-intubation stenosis with tracheal T-tube proved effective when the tracheal resection was not possible.