Department of General Thoracic Surgery, Kochi Health Sciences Center, Kochi, Japan.
Asian J Endosc Surg. 2024 Jul;17(3):e13356. doi: 10.1111/ases.13356.
Tracheal injury during mediastinoscopic esophagectomy is a life-threatening complication that is challenging to manage. However, no precise treatment has been defined. An 80-year-old male patient with upper esophageal cancer underwent a mediastinoscopic esophagectomy and gastric tube reconstruction through the posterior mediastinal route. When the esophagus was separated from the trachea using a bipolar vessel sealing system, the left side of the membranous trachea incurred a 3-cm defect 7 cm below the sternal notch. We successfully repaired the tracheal injury not by directly suturing the defect but by reinforcing it with a pedicle sternocleidomastoid flap. The gastric tube was placed over the tracheal repair for esophageal reconstruction via a posterior mediastinal route. As a result, the patient recovered well and was discharged. A sternocleidomastoid flap might be another surgical option for reinforcement flaps in tracheal injuries.
在纵隔镜食管切除术期间发生的气管损伤是一种危及生命的并发症，处理起来具有挑战性。然而，目前还没有明确的治疗方法。一名 80 岁男性患者因上段食管癌接受了纵隔镜食管切除术和胃管重建，通过后纵隔途径。当使用双极血管密封系统将食管与气管分离时，膜性气管的左侧在胸骨切迹以下 7 厘米处发生了 3 厘米的缺损。我们成功地修复了气管损伤，不是通过直接缝合缺损，而是通过带蒂胸锁乳突肌瓣进行加固。将胃管放置在气管修复部位上方，通过后纵隔途径进行食管重建。结果，患者恢复良好并出院。胸锁乳突肌瓣可能是气管损伤加固瓣的另一种手术选择。
