[Primary tracheal tumors of the neck and mediastinum : resection and reconstruction procedures].
Primary tumors of the trachea account for less than 0.1% of all tumors. They are malignant in more than 90% of cases with squamous cell carcinoma and adenoidcystic carcinoma accounting for 2/3 of all tracheal tumors. Since they are often misdiagnosed as asthma or chronic lung disease, diagnosis can be delayed for years. Once the diagnosis has been established, surgical resection being the only curative treatment should be considered first. Modern techniques for tracheal surgery such as laryngotracheal, tracheal or carinal resection and different tracheal mobilisation maneuvers such as laryngeal and hilar release allow for resection of more than 50% of the trachea and anastomosis without excessive tension. Results in patients with complete tumor resection are good with 5-year and 10-year survival between 39% and 79% and between 18% and 51%, respectively. However, careful patient evaluation, preservation of tracheal blood supply and accepting the limits of resectability are mandatory to avoid major complications that accompany tracheal resections in more than 20% of cases depending on the type of resection.
Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Giessen und Marburg, Standort Giessen, Deutschland. ruediger.hoerbelt@chiru.med.uni-giessen.de
R
R
Hoerbelt
W
W
Padberg
D000402:Airway Obstruction / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D003528:Carcinoma, Adenoid Cystic / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D044964:Cervicoplasty / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis / Q000473:pathology; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012307:Risk Factors; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000098:blood supply / Q000294:innervation / Q000473:pathology / Q000601:surgery; D014134:Tracheal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*
J Comput Assist Tomogr. 2002 May-Jun;26(3):335-41
12016358
Ann Thorac Surg. 2004 Dec;78(6):1889-96; discussion 1896-7
15560996
Ann Otol Rhinol Laryngol. 1969 Apr;78(2):285-96
5775394
Ann Thorac Surg. 1982 Oct;34(4):356-73
7138104
World J Surg. 1980 Sep;4(5):583-91
7233928
Ann Thorac Surg. 1989 Oct;48(4):469-73; discussion 473-5
2478088
Ann Otol Rhinol Laryngol. 1998 Sep;107(9 Pt 1):790-6
9749550
Ann Otol Rhinol Laryngol. 1974 Jan-Feb;83(1):71-5
4811582
J Thorac Cardiovasc Surg. 1968 Mar;55(3):418-21
5642707
J Thorac Cardiovasc Surg. 1996 Dec;112(6):1522-31; discussion 1531-2
8975844
Thorax. 1993 Jul;48(7):688-92
8153914
J Pediatr. 1949 Jul;35(1):63-9
18132987
J Thorac Cardiovasc Surg. 1996 Apr;111(4):808-13; discussion 813-4
8614141
Clin Chest Med. 1987 Jun;8(2):231-40
3304813
Ann Otol Rhinol Laryngol. 1971 Feb;80(1):6-12
5541885
Otolaryngol Head Neck Surg. 2004 Nov;131(5):639-42
15523440
Ann Thorac Surg. 1978 Aug;26(2):112-25
208474
JAMA. 1971 Jun 21;216(12):1984-8
5108629
Thorac Surg Clin. 2004 Feb;14(1):79-86
15382311
Chest Surg Clin N Am. 1996 Nov;6(4):875-98
8934015
Chest. 1999 Jun;115(6):1500-6
10378540
Eur J Cardiothorac Surg. 2001 Mar;19(3):339-45
11251276
Chest Surg Clin N Am. 1996 Nov;6(4):675-82
8934000
Chest Surg Clin N Am. 2001 Nov;11(4):735-48
11780293
Chest Surg Clin N Am. 2003 May;13(2):385-97
12755323
J Natl Cancer Inst. 1989 Dec 6;81(23):1828-31
2585530
Ann Thorac Surg. 1977 Aug;24(2):100-7
327958
Acta Otolaryngol. 1991;111(6):1162-9
1763640
Arch Otolaryngol. 1974 Apr;99(4):255-60
4594223
Chest Surg Clin N Am. 2003 May;13(2):191-9, v
12755308