Perelman M, Korolyova N
Thorax. 1968 May;23(3):307-10. doi: 10.1136/thx.23.3.307.
We have operated on nine patients suffering from benign or malignant tumours in the thoracic portion of the trachea. The main clinical symptom was difficulty in breathing, accompanied in the majority of cases by attacks of asphyxia, cough with mucous phlegm, and haemoptysis. The following operations were performed: circular resection of the trachea with end-to-end anastomosis, thoracic tracheotomy with enucleation of the tumour, fenestral resection with auto-alloplasty of the ensuing defect, piecemeal removal of the tumour through the lumen of the trachea, and intrathoracic tracheotomy with biopsy of the tumour. All patients were discharged after the operation. When giving an anaesthetic during an operation on the thoracic portion of the trachea it is expedient to introduce a tube into the left main bronchus from the right pleural cavity and to exclude the right lung from ventilation. These measures ensure convenience of manipulation of the trachea, unhampered by the presence of a tube. End-to-end anastomosis is the best way to restore the thoracic portion of the trachea after circular resection. The problem of replacing large fenestral defects of the trachea can be solved by auto-alloplasty with thick Marlex, preliminarily overgrown with connective tissue.
我们已对9例患有气管胸段良性或恶性肿瘤的患者进行了手术。主要临床症状为呼吸困难，多数情况下伴有窒息发作、咳痰咳嗽和咯血。实施了以下手术：气管环形切除并端端吻合、胸段气管切开并摘除肿瘤、开窗切除并对随后的缺损进行自体移植成形术、经气管腔分块切除肿瘤以及胸段气管切开并对肿瘤进行活检。所有患者术后均已出院。在气管胸段手术中进行麻醉时，从右胸腔将一根导管插入左主支气管并使右肺不参与通气是适宜的。这些措施可确保气管操作方便，不受导管存在的妨碍。端端吻合是气管环形切除后修复气管胸段的最佳方法。气管大的开窗缺损的修复问题可通过用预先已被结缔组织覆盖的厚Marlex进行自体移植成形术来解决。
