Journal of Medical and Surgical
Research (JMSR)


...

Pages: 979-983

Date of Publication: 30-Nov--0001

Tracheobronchial Surgery: Experience of The Thoracic Surgery Department in Fez- Morocco.

Author: Marouane Lakranbi , Hicham Harmouchi, Fatima Zahra Ammor, Laila Belliraj, Fatima Zahra Lamouime, Yassine Ouadnouni, Mohamed Smahi

Category: JMSR Surgery

[Download PDF]

Abstract:

Introduction: Tracheobronchial resections with anastomosis are not very common. They are mostly indicated in post-intubation tracheal stenosis and tracheal tumors (80% of which are malignant). As for bronchoplastic pulmonary resections, they are mainly applied to bronchopulmonary cancer. The goal of this surgery is to allow a carcinological resection with an optimal conservation of a good respiratory function. The purpose of this study isto discussthe indications, surgical techniques and prognosis of tracheal resections and bronchoplasty. Materials and Methods: It is a retrospective study including 30 patients who underwent tracheobronchial resection with anastomosis over 10 years (2010-2019) in the thoracic surgery department at Hassan IId University hospital in Fez-Morocco. Results: A total of 30 patients were operated on, divided in 2 groups: the first group with 20 cases of tracheal disease and the second group with 10 cases of bronchial disorder. The 1st group includes 11 cases of post-intubation tracheal stenosis and 9 cases of tracheal tumors. The surgical approach was mainly through a cervical approach with cervicotomy in 8 cases. End-to-end tracheal anastomosis was performed in 13 patients. Two deaths were reported: the first patient died on day 4 from cataclysmic hemothorax and the second 8 months after surgery by complications related to post-radiation tracheal stenosis. In the second group, the bronchial condition consisted of carcinoid tumors in 80% of cases (8 patients). Posterolateral thoracotomy was performed in all patients. They initially underwent lung resection followed by bronchoplasty. The post-operative course was uneventful. Conclusion: The prognosis of tracheobronchial surgery is influenced by patient selection and the mastering of the tracheal surgical techniques. For bronchoplastic surgery, the fresh mount study of the sections plays a major role.

Keywords: Anastomosis, Bronchi, Thoracic Surgery, Trachea, Morocco

References:

  1. Grillo HC, Mathisen DJ. The trachea. Ann Thorac Surg 1990;49:845-6.
  2. Grillo HC, Mathisen DJ, Wain JC. Management of tumors of the trachea. Oncology (Williston Park) 1992;6:61-7.
  3. Thomas CP. Conservative resection of the bronchial tree [J]. J R Coll Surg Edinb. 1956;1:169–86.
  4. P. Macchiarini, Primary tracheal tumours, Lancet Oncol. 7 (2006) 83–91.
  5. M. Abdennadher, C. Rivera, L. Gibault, E. Fabre, C. Pricopi, A. Arame, et al., Tumeurs muco-épidermoïdes trachéo-bronchiques chez l’adulte. À propos d’une série de 22 cas, Rev. Pneumol. Clin. 71 (2015) 27–36.
  6. M. Seemann, J.M. Schaefer, K.H. Englmeier, Virtual positron emission tomography/ computed tomography-bronchoscopy: possibilities, advantages and limitations of clinical application, Eur. Radiol. 17 (2007) 709–715.
  7. H.C. Grillo, Development of tracheal surgery: ahistorical review. Part 1: techniques of tracheal surgery, Ann. Thorac. Surg. 75 (2003) 610–619.
  8. H.C. Grillo, Development of tracheal surgery: a historical review. Part 2: treatment of tracheal diseases, Ann. Thorac. Surg. 75 (2003) 1039–1047.
  9. S. Rouzé, E. Flécher, B. De Latour, C. Meunier, M. Sellin, H. Lena, J.P. Verhoye, Carcinome adénoïde kystique trachéal traité par reconstruction complète de la carène sous ECMO : à propos d’un cas, Rev. Pneumol. Clin. 69 (2013) 144-148.
  10. Gaissert HA et al. Survival and function after sleeve lobectomy for lung cancer. J Thorac Cardiovasc Surg 1996; 111: 948—53.
  11. Mark F Berry, Mathias Worni, Xiaofei Wang, David H Harpole, Thomas A D'Amico, Mark W Onaitis. Sleeve lobectomy for non-small cell lung cancer with N1 nodal disease does not compromise survival. Ann Thorac Surg. 2014 Jan; 97 (1):230-5.