Anterior Mediastinal Tracheotomy

Kleitsch, William P.

doi:10.1016/s0096-5588(20)31095-3

Cited by 18 publications

(2 citation statements)

References 1 publication

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“…AMT was first reported in 1952 by William P. Kleitsch (5) and George Minor (6), respectively, for treating recurrent tracheal tumors. In 1959, William R. Waddell et al (7) described a technique for subtotal excision of the trachea and establishing a sternal tracheostomy in four patients.…”

Section: Discussionmentioning

confidence: 99%

Application of low anterior mediastinal tracheostomy for locally advanced cervicothoracic esophageal cancer undergoing total laryngopharyngoesophagectomy: a case report

Chen¹,

Flores²,

Kidane³

et al. 2021

J Gastrointest Oncol

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A sixty-six year-old woman came to hospital, complaining of dysphagia and weight loss.Esophagoscope showed a neoplasm between 15 and 20 cm from the incisors, biopsy revealed esophageal squamous cell carcinoma. Chest computed tomography (CT) showed that the cervical esophageal wall became thicker, the narrowing of the lumen extended downwards to the upper thoracic esophagus. Tumor invaded the membranous parts of the 5th to 12th rings of the trachea, and no swollen lymph nodes were observed in the mediastinum. The clinical stage was cT4N0M0 with borderline resectable possibility.The patient was assessed with stable disease after receiving two courses of neoadjuvant chemotherapy using DTX/CDDP/5-FU strategy. After a standard multidisciplinary treatment evaluation, total laryngopharyngoesophagectomy plus low anterior mediastinal tracheostomy (AMT) was performed. To ensure radical resection, we innovatively adopted the application of Double S-shaped myocutaneous flaps, which helps to extend the trachea and facilitate the stoma. Meanwhile, we removed the upper sternum, sternum stem, clavicle head and first and second costal cartilage to facilitate the tracheostomy and reduce the space around the stoma to avoid fluid accumulation. The pathological result showed pT 4b N 0 M 0 stage with partial response after neoadjuvant chemotherapy. This patient developed a minor anastomotic leakage which was effectively managed. Finally, she was discharged successfully 21 days after surgery.

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Section: Discussionmentioning

confidence: 99%

Application of low anterior mediastinal tracheostomy for locally advanced cervicothoracic esophageal cancer undergoing total laryngopharyngoesophagectomy: a case report

Chen¹,

Flores²,

Kidane³

et al. 2021

J Gastrointest Oncol

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“…Cervical tracheostomy (CT) is the first choice, whereas anterior mediastinal tracheostomy (AMT) is sometimes required because of the tumor extension or insufficient blood supply to the tracheal tip. In 1952, AMT for a case with stomal recurrence was first described, 7 and Grillo 8 reported 2 patients with favorable postoperative courses after PLTE with AMT in 1966. However, in practice, PLTE with AMT is more challenging when compared with CT because AMT may cause severe postoperative complications, such as bleeding from the major vessels (eg, brachiocephalic artery).…”

Section: Introductionmentioning

confidence: 99%

Postoperative Complications Following Pharyngolaryngectomy With Total Esophagectomy: Comparison Between Cervical and Anterior Mediastinal Tracheostomy

Kanie

Okamura

Kanamori

et al. 2022

Ann Otol Rhinol Laryngol

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Objectives: Pharyngolaryngectomy with total esophagectomy (PLTE) is associated with high morbidity and mortality rates. Cervical tracheostomy (CT) is the first choice of tracheostomy, whereas anterior mediastinal tracheostomy (AMT) is sometimes required due to tumor extension or insufficient blood supply to the tracheal tip. However, the differences in the outcomes between CT and AMT after PLTE remain unclear. Methods: We retrospectively reviewed 67 patients who underwent PLTE and compared the clinical features and postoperative complications between patients with CT and AMT. The characteristics and the outcomes were compared between the groups stratified by the causes of AMT. Results: Of the 67 patients, 42 (62.7%) patients underwent PLTE with CT (CT group), whereas 25 (37.3%) underwent PLTE with AMT (AMT group). The AMT group included more cervicothoracic esophageal cancers and had showed an advanced T stage compared to the CT group ( P < .01 and .01, respectively). The incidences of pneumonia and surgical site infection (SSI) were more frequent in the AMT group than in the CT group ( P = .03 and .01, respectively). Surgery-related mortality was only observed in the AMT group. In the AMT group, 17 (68.0%) and 8 (32.0%) patients underwent AMT because of tumor extension and insufficient supply to the tracheal tip. The latter cases underwent transthoracic esophagectomy more frequently than former cases ( P = .03). Conclusion: AMT after PLTE had more postoperative complications and mortality than CT. In cases that may need AMT, a transthoracic approach is preferable over transhiatal esophagectomy to avoid fatal complications when oncologically permissive.

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TUMORS OF THE NOSE AND THROAT: Summaries of the Bibliographic Material Available in the Field of Otolaryngology from February, 1951, to August, 1953

Figi¹,

Devine²

1955

Archives of Otolaryngology - Head and Neck Surgery

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Anterior Mediastinal Tracheotomy

Cited by 18 publications

References 1 publication

Application of low anterior mediastinal tracheostomy for locally advanced cervicothoracic esophageal cancer undergoing total laryngopharyngoesophagectomy: a case report

Application of low anterior mediastinal tracheostomy for locally advanced cervicothoracic esophageal cancer undergoing total laryngopharyngoesophagectomy: a case report

Postoperative Complications Following Pharyngolaryngectomy With Total Esophagectomy: Comparison Between Cervical and Anterior Mediastinal Tracheostomy

TUMORS OF THE NOSE AND THROAT: Summaries of the Bibliographic Material Available in the Field of Otolaryngology from February, 1951, to August, 1953

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