Nomori H, Nara S
Department of Surgery, Saiseikai Central Hospital.
Kyobu Geka. 1991 May;44(5):384-6.
The patient was a 58-year-old male with tracheostomal recurrence after surgery for laryngeal carcinoma. After median sternotomy, half of the bilateral clavicula, the anterior portion of the bilateral 1st ribs, and the upper portion of the sternum were resected. The tumor was resected with the muscle layer of the esophagus and the left internal jugular vein. A left internal jugular vein was reconstructed from the major saphenous vein. The trachea was resected at a position of 5 rings from the carina, and then a tracheostoma was made. At an early stage after surgery, there was no problem associated with the tracheostoma. Three months after surgery, stenosis of stoma occurred, but temporary intubation of the trachea released the stenosis completely. From this result, we concluded that when anterior mediastinal tracheostomy is performed for tracheostomal recurrence with invasion to the major vessels, addition of a median sternotomy is a safe and beneficial procedure.