title: Tracheal resection for malignant and benign diseases: surgical results and perioperative considerations.
abstract: OBJECTIVE
  Tracheal surgery is an established treatment for various diseases; however, it is still a potentially challenging procedure. We herein discuss the safety of this procedure with regard to the coordination with airway interventional and anesthetic support.
  
  
  METHODS
  A tracheal resection was performed on 18 patients. The dyspnea due to pre-existing severe airway stenosis, which was considered to be a risk factor for the safe induction of general anesthesia, was present in 12 (66.7%) cases.
  
  
  RESULTS
  Seven of the 12 patients with pre-existing airway obstruction required interventional airway treatment before surgery. One case with a polyp-like tracheal tumor required venoarterial percutaneous cardiopulmonary support to establish adequate oxygenation before surgery. All 18 cases underwent a segmental resection of the trachea, with the average length of 3.6 rings. Postoperative recovery was uneventful for all but one patient with postintubation tracheal stenosis, who died 17 days after surgery due to a methicillin-resistant Staphylococcus aureus infection. Complications in the other patients included four cases of laryngeal nerve palsy, three of aspiration, and one patient with Horner syndrome, with a total morbidity of 27.7%.
  
  
  CONCLUSIONS
  A tracheal resection is currently a safe procedure; however, cooperation with sophisticated airway interventional treatment teams, cardiopulmonary bypass support, or a well-trained anesthesiologist is essential for obtaining a successful outcome, especially for the cases with pre-existing severe airway obstruction.
authors: Department of Thoracic, Endocrine and Pediatric Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Johnan-ku, Fukuoka, 814-0180, Japan.
authors: Takeshi
authors: T
authors: Shiraishi
authors: Jun
authors: J
authors: Yanagisawa
authors: Takao
authors: T
authors: Higuchi
authors: Masafumi
authors: M
authors: Hiratsuka
authors: Daisuke
authors: D
authors: Hamatake
authors: Naoyuki
authors: N
authors: Imakiire
authors: Toshiro
authors: T
authors: Ohbuchi
authors: Yasuteru
authors: Y
authors: Yoshinaga
authors: Akinori
authors: A
authors: Iwasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery; D000758:Anesthesia / Q000379:methods; D001706:Biopsy; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D016019:Survival Analysis; D014133:Tracheal Diseases / Q000150:complications / Q000601:surgery*; D014134:Tracheal Neoplasms / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome