Unique clinical cases of extensive tracheal resections in malignant neoplasms
Borysiuk B.O., Hanul V.A., Velychko V.V., Borysiuk Yu.V., Sovenko V.M., Suprun G.O.
Summary. Primary tracheal tumors are rare entities and are often diagnosed at advanced stages due to nonspecific clinical symptoms. Surgical treatment remains the only radical therapeutic option. Traditionally, the safe length of tracheal resection has been considered to be limited to 4–6 tracheal rings; however, advances in surgical technique and anesthesiology have made more extended resections feasible without increasing the risk of anastomotic complications. This article presents 2 unique clinical cases of extended tracheal resections in patients with tumors of malignant potential. The 1st case describes a 67-year-old female with critical upper tracheal obstruction caused by a tracheal schwannoma, initially diagnosed as benign but later confirmed to have malignant features on postoperative immunohistochemical examination. The patient underwent resection of five tracheal rings with primary cricotracheal anastomosis and demonstrated no evidence of disease recurrence during three years of follow-up. The 2nd case involves a 61-year-old female diagnosed with adenoid cystic carcinoma of the trachea. Due to the longitudinal spread of the tumor, an extended resection of nine tracheal rings with primary tracheotracheal anastomosis was performed, achieving an R0 resection. The postoperative course was uneventful, with satisfactory airway patency and no signs of local recurrence during follow-up. These cases demonstrate that extended tracheal resections exceeding conventional length limits can be safely performed in specialized centers and may provide favorable oncological and functional outcomes in selected patients.
Leave a comment