File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Manubrial resection and anterior mediastinal tracheostomy: Friend or Foe?

TitleManubrial resection and anterior mediastinal tracheostomy: Friend or Foe?
Authors
Keywordsanterior mediastinal tracheostomy
innominate artery rupture
Level of Evidence: 4
Manubrial resection
stenosis of tracheostomy
Issue Date2011
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/
Citation
Laryngoscope, 2011, v. 121 n. 7, p. 1441-1445 How to Cite?
AbstractObjectives/Hypothesis: To review our experience with manubrial resection and anterior mediastinal tracheostomy and formulate operative guidelines to improve the surgical outcome. Study Design: Retrospective study. Methods: Between January 1980 and June 2010, we performed 38 manubrial resections. The indications of the procedure, reconstructive methods, and operative outcomes were analyzed. Results: Fourteen patients had tumors of the hypopharynx/cervical esophagus, eight had parastomal recurrences of laryngeal tumor, four had recurrent esophageal tumors, four had postirradiation sarcoma, four suffered from subglottic/upper tracheal tumors, three had thyroid malignancy, and the remaining patient had tumor recurrence at the previous tracheostomy site. The hospital mortality rate was 5.3% due to bleeding from major vessel erosion. The mean length of the tracheal stump was 5.4 cm, of which 81.6% required relocation inferior to the innominate artery for construction of the mediastinal tracheostomy. Among the different reconstructive methods for the pharyngoesophageal defects, the anastomotic leakage rate was 17.6%, the majority of which required exteriorization followed by second stage reconstruction. The long-term tracheostomy stenosis rate was 47.4%, the risk of which was significantly increased by anastomotic leakage and necrosis of distal trachea. The use of a pectoralis major flap was shown to protect against this complication. The overall survival was 80.6% at 1 year and 55.6% at 5 years after surgery. Conclusions: With attention to operative details, manubrial resection and anterior mediastinal tracheostomy is a safe procedure with acceptable outcome. It should be performed when indicated to facilitate tumor resection in the cervicothoracic region. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/137549
ISSN
2015 Impact Factor: 2.272
2015 SCImago Journal Rankings: 1.342
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, YWen_HK
dc.contributor.authorYu Chow, VLen_HK
dc.contributor.authorLun Liu, LHen_HK
dc.contributor.authorIgnace Wei, Wen_HK
dc.date.accessioned2011-08-26T14:27:51Z-
dc.date.available2011-08-26T14:27:51Z-
dc.date.issued2011en_HK
dc.identifier.citationLaryngoscope, 2011, v. 121 n. 7, p. 1441-1445en_HK
dc.identifier.issn0023-852Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/137549-
dc.description.abstractObjectives/Hypothesis: To review our experience with manubrial resection and anterior mediastinal tracheostomy and formulate operative guidelines to improve the surgical outcome. Study Design: Retrospective study. Methods: Between January 1980 and June 2010, we performed 38 manubrial resections. The indications of the procedure, reconstructive methods, and operative outcomes were analyzed. Results: Fourteen patients had tumors of the hypopharynx/cervical esophagus, eight had parastomal recurrences of laryngeal tumor, four had recurrent esophageal tumors, four had postirradiation sarcoma, four suffered from subglottic/upper tracheal tumors, three had thyroid malignancy, and the remaining patient had tumor recurrence at the previous tracheostomy site. The hospital mortality rate was 5.3% due to bleeding from major vessel erosion. The mean length of the tracheal stump was 5.4 cm, of which 81.6% required relocation inferior to the innominate artery for construction of the mediastinal tracheostomy. Among the different reconstructive methods for the pharyngoesophageal defects, the anastomotic leakage rate was 17.6%, the majority of which required exteriorization followed by second stage reconstruction. The long-term tracheostomy stenosis rate was 47.4%, the risk of which was significantly increased by anastomotic leakage and necrosis of distal trachea. The use of a pectoralis major flap was shown to protect against this complication. The overall survival was 80.6% at 1 year and 55.6% at 5 years after surgery. Conclusions: With attention to operative details, manubrial resection and anterior mediastinal tracheostomy is a safe procedure with acceptable outcome. It should be performed when indicated to facilitate tumor resection in the cervicothoracic region. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/en_HK
dc.relation.ispartofLaryngoscopeen_HK
dc.rightsThe Laryngoscope. Copyright © John Wiley & Sons, Inc.-
dc.subjectanterior mediastinal tracheostomyen_HK
dc.subjectinnominate artery ruptureen_HK
dc.subjectLevel of Evidence: 4en_HK
dc.subjectManubrial resectionen_HK
dc.subjectstenosis of tracheostomyen_HK
dc.subject.meshHead and Neck Neoplasms - mortality - pathology - surgery-
dc.subject.meshManubrium - pathology - surgery-
dc.subject.meshNeoplasm Recurrence, Local - mortality - pathology - surgery-
dc.subject.meshReconstructive Surgical Procedures - adverse effects - methods-
dc.subject.meshTracheostomy - adverse effects - methods-
dc.titleManubrial resection and anterior mediastinal tracheostomy: Friend or Foe?en_HK
dc.typeArticleen_HK
dc.identifier.emailChan, YW: jywchan1@hku.hken_HK
dc.identifier.authorityChan, YW=rp01314en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/lary.21852en_HK
dc.identifier.pmid21594875-
dc.identifier.scopuseid_2-s2.0-79959374445en_HK
dc.identifier.hkuros190784en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79959374445&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume121en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1441en_HK
dc.identifier.epage1445en_HK
dc.identifier.eissn1531-4995-
dc.identifier.isiWOS:000292425300016-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, YW=27171772200en_HK
dc.identifier.scopusauthoridYu Chow, VL=37462593200en_HK
dc.identifier.scopusauthoridLun Liu, LH=37075178000en_HK
dc.identifier.scopusauthoridIgnace Wei, W=50461498300en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats