Video-assisted thoracoscopic surgery resection and reconstruction of thoracic trachea in the management of a tracheal neoplasm

Abstract

Intratracheal tumor is a rare tumor, accounting for only 2% of upper respiratory tract neoplasms. Its symptoms are similar to those of head and neck cancers, including coughing up blood, sore throat, and airway obstruction. The diagnosis of this disease is often based on the findings of fibrobronchoscopy or computed tomography (CT). Surgery remains the treatment of choice for tracheal tumor. In patients with benign neoplasms or if the tumors have limited involvement, fibrobronchoscopic resection of the tumor can be performed. For malignant tumors, however, radical resection is required. In the past, open incision is used during the surgery for tumors located in thoracic trachea. Along with advances in video-assisted thoracoscopic surgery (VATS) minimally invasive techniques and devices, VATS resection and reconstruction of the trachea can achieve the radical resection of the tumor and meanwhile dramatically reduce the injury to the patients. In this article we describe the application of VATS resection and reconstruction of trachea in the management of a tracheal neoplasm.

Robotic circumferential tracheal resection and reconstruction via a completely portal approach

“…Surgical resection is one of the essential treatments for primary tracheal tumor. This procedure using a video‐assisted thoracoscopic approach has been reported by several studies . Furthermore, our team was the first to report the use of robotic‐assisted non‐circumferential tracheal resection and reconstruction for leiomyoma .…”

“…The majority of these procedures are performed by thoracotomy or median sternotomy. Recently, video‐assisted thoracoscopic surgery has been gradually applied in high‐volume centers . However, whether a robotic approach is competent for tracheal surgery has not been well defined.…”

“…Recently, video-assisted thoracoscopic surgery has been gradually applied in high-volume centers. 1,2 However, whether a robotic approach is competent for tracheal surgery has not been well defined. Herein we describe a patient with primary leiomyosarcoma in the lower trachea who underwent circumferential tracheal resection and telescope anastomosis via a completely portal robotic approach with four arms (Video S1).…”

Thoracoscopic tracheal resection and reconstruction: video-assisted thoracoscopic surgery as a “tool” toward minimally invasive surgery

“…Tracheal circumferential resection and reconstruction by VATS had been first reported by Dr. Nakanishi and Kuruma in 2005 (4), and only a small number of cases have been reported mostly from Chinese institutes including the GMU hospital (3,5,6). The GMU team also employs VATS for more complex procedures such as carinal reconstruction (6,7), which had been first reported by Dr. Nakanishi et al in 2013 (8).…”

Confronting the fundamental challenges of airway surgery: a paradigm shift is practically upon us

“…The authors' conclusion supports this view: "it (tracheal resection) remains a highly challenging procedure for most medical teams." (1).…”