Document Detail

As originally published in 1992: Anterior mediastinal tracheostomy with and without cervical exenteration. Updated in 1998.
MedLine Citation:
PMID:  10197709     Owner:  NLM     Status:  MEDLINE    
Anterior mediastinal tracheostomy (AMT) facilitates resection of stomal recurrences after laryngectomy for carcinoma and tumors involving the cervicothoracic trachea and esophagus. Erosion of the innominate artery has been reported as a frequent major complication of AMT, and routine prophylactic division of the innominate artery with AMT has even been advised. Forty-four patients underwent AMT, 10 as an isolated procedure (for stomal recurrence, laryngeal carcinoma, or benign stenosis after laryngectomy) and 34 with concomitant cervical exenteration (laryngopharyngoesophagectomy) for laryngeal, thyroid, or cervicothoracic esophageal malignancies. Transposition of the remaining tracheal stump beneath and to the right of the innominate artery to eliminate tension on the vessel was carried out in 14 patients (32%). Postoperatively, anastomotic leaks complicated nine of 31 pharyngogastric anastomoses. Iatrogenic hypoparathyroidism occurred in 10 patients. All six hospital deaths (14%) occurred in patients undergoing AMT with cervical exenteration, not isolated AMT. There was only one instance of innominate artery erosion. Survival was related to the pathology for which AMT was performed. Anterior mediastinal tracheostomy is a valuable adjunct in the treatment of select patients with malignancies of the cervicothoracic trachea and esophagus, and with attention to operative detail, innominate artery erosion should rarely, if ever, complicate the operation. Prophylactic division of the innominate artery with AMT is unnecessary.
M B Orringer
Related Documents :
3986059 - Normal intracardiac and great artery blood velocity measurements by pulsed doppler echo...
2413569 - Morphological observations following "anatomical correction" for abnormal ventriculo-ar...
20111649 - Long-term outcomes after an arterial switch operation for simple complete transposition...
16613229 - Arterial switch operation using aortic homograft for transposition of the great arterie...
3336229 - The early results of treatment of simple transposition in the current era.
2483339 - Palliative mustard operation: an expanded horizon.
3025009 - Myocyte cytochrome oxidase activity and neuromuscular conduction associated with metabo...
2528509 - The influence of the atrial natriuretic factor on venous tone in man.
7972779 - Abdominal aortic aneurysms: evaluation with variable-collimation helical ct and overlap...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  67     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-04-23     Completed Date:  1999-04-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  591     Citation Subset:  AIM; IM    
Department of Surgery, The University of Michigan Medical Center, Ann Arbor 48109, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Esophageal Neoplasms / surgery*
Laryngectomy / methods
Neck Dissection / methods*
Neoplasm Recurrence, Local / surgery
Tracheal Neoplasms / surgery*
Tracheostomy / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Mediastinal parathyroid cysts revisited.
Next Document:  Longevity, genes, and aging: a view provided by a genetic model system.