[Anesthesia and operative approach of resection of the trachea].
OBJECTIVE
Review and discuss anesthesia and operative approach of resection of the trachea for different tracheal diseases, especially for the resection of long-segment of trachea. At the same time to introduce the method of reconstruction of long-segment of trachea with Zhao's (two-stage procedure with memory-alloy mesh) artificial trachea.


METHODS
Retrospective study of 18 cases of tracheal resection, analysis of the relation between the choice of anesthetic and operative approach.


RESULTS
General anesthesia through cut open the trachea with local anesthesia in 2 cases, general anesthesia through previous tracheotomy in 2 cases, extracorporeal circulation in 2 cases, general anesthesia through endotracheal tube in 12 cases. There were no anesthetic or operative death. Local resection in 3 cases, segmental resection in 15 cases. The longest segmental resection was 8.0 cm. Primary anastomosis after segmental resection in 8 cases, Reconstruction with Zhao's artificial trachea in 7 cases. Postoperative follow-up was 5 months to 8 years. Four cases died from systemic metastasis or other reasons at 4, 11 and 12 months, respectively.


CONCLUSIONS
Different methods of anesthetic and operative procedures should be used for different patients. Extracorporeal circulation used for patient with highest dangerous condition, or, for which could be inserted endotracheal tube by tracheotomy with local anesthesia. Conservative local resection performed only for patients with very bad general condition. Segmental resection less than 5 cm long could be reconstructed with primary reanastomosis. Resection longer than 5.5 cm could be reconstructed with Zhao's artificial trachea.
Zhao
Feng-rui
FR
Department of Thoracic Surgery, Beijing Jian'gong Hospital, Beijing 100054, China. zhaofr2002@yahoo.com.cn
Zhang
Yin-he
YH
Yang
Jin-long
JL
Xing
Xue-zhong
XZ
Yun
Kuo
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D000772:Anesthesia, Local; D001187:Artificial Organs; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D013908:Thoracotomy; D014133:Tracheal Diseases / Q000601:surgery; D014140:Tracheotomy / Q000379:methods*