An unusual salvage technique for posterior tracheal membranous laceration associated with transhiatal esophagectomy: A transcervical–transsternal approach

Seyed Ziaeddin Rasihashemi, Nassir Rostambeigi, Seyed Reza Saghebi, Faeze Daghigh, Ali Ramouz

Research output: Contribution to journalArticlepeer-review

Abstract

Various surgical approaches may be employed for esophageal resection. Major airway injuries due to transhiatal esophagectomy include vertical tears in the membranous trachea. Tracheal injury is an uncommon but potentially fatal complication. This article describes the technique to repair the posterior membranous tracheal tear, extended just over the carina through a transcervical–transsternal approach, thereby avoiding a second thoracotomy. Six patients with posterior membranous tracheal injury underwent this procedure. The laceration ranged from 3 cm to 5 cm in length. Four patients had received neoadjuvant chemoradiation. The management of tracheal laceration added approximately 60 minutes to the total operation time. There was no mortality related to tracheal injury. Patients were followed up for 6 months after surgery, and both posterior tracheal wall and transverse tracheotomy remained intact without stenosis. The transcervical–transsternal approach decreases the need of thoracotomy and its complications in patients with tracheal laceration in any stage, even in cases of an extended tear down to the carina.

Original languageEnglish (US)
Pages (from-to)415-418
Number of pages4
JournalAsian Journal of Surgery
Volume40
Issue number5
DOIs
StatePublished - Sep 2017

Bibliographical note

Publisher Copyright:
© 2016

Keywords

  • esophagectomy
  • laceration
  • trachea
  • transcervical
  • transhiatal

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