Tracheal resection and reconstruction: A 3-year case series of 14 patients

Abstract

Introduction: Tracheal resection and reconstruction is one of the most challenging procedures and is seldom performed due to its complexity. Despite being a life-saving procedure, only a handful of centres are performing this procedure in Malaysia. We report our 3 years' experience in Hospital Kuala Lumpur performing tracheal resection and reconstruction in 14 patients.

Materials and methods: Retrospective review of medical records of tracheal resection and reconstruction was performed from September 2018 till August 2021. Data that were extracted include demographic information, indication for surgery, intraoperative airway management, surgical approach, perioperative parameters, complications, and 1- year outcome.

Results: Fourteen patients with the mean age of 49.1 years underwent tracheal resection and reconstruction, consisting of 9 benign and 5 malignant diseases. Non-intubated airway approach was used in three patients. Transcervical surgical access was used in 10 patients whereas thoracotomy, videoassisted thoracoscopic surgery, and combination of thoracotomy, transcervical incision with manubrial split were used in 3 patients respectively. The mean length of trachea resected was 2.3cm, with the longest length of 4.5cm. All patients were extubated post-operatively except for one due to traumatic brain trauma. No anastomosis dehiscence was seen. We also did not see any postoperative stenosis and all the patients are alive.

Conclusion: Tracheal resection and anastomosis can be performed safely in complex stenosis and malignant tumours. Pre-operative planning with a multidisciplinary approach is vital to ensure a good outcome.