Treatment of Thoracic Tracheal Stenosis by Sternotomy Approach / 대한이비인후과학회지

ABSTRACT

BACKGROUND: The treatment for thoracic tracheal stenosis is somewhat different from cervical tracheal stenosis, because it needs approach to the thoracic cavity which contains vital organs such as heart and great vessels. The classic surgical approach to thoracic trachea has been either the posterolateral thoracotomy or through the median sternotomy approach, with the former being preferred to the latter. The purpose of this study is to determine the results of the sternotomy method to approach the thoracic cavity in the management of thoracic tracheal stenosis. MATERIALS AND METHODS: From 1996 to 1998, 4 patients with thoracic tracheal stenosis had surgical treatment through various sternotomy approach. A retrospective study was done about various postoperative values. RESULTS: There has been no operative mortality. Hospital stay ranged from 24 to 55 days (mean 38.5+/-12.9 days). No pulmonary complication occurred postoperatively. There were three cases of postoperative wound infection and mediastinitis. But all of them could be treated with early open drainage, debridement, and greater omentum free flap. And there was no postoperative mortality. CONCLUSIONS: In order to reduce postoperative infection, the strategy of median sternotomy can be used for thoracic tracheal stenosis, because it is simple, easy to perform, provides more physiological ventilation-perfusion condition during the operation and has short operation time, good operation field, low postoperative pulmonary complication rate, and short hospital stay.