전종격동 기관절개술 이후에 발생한 무명동맥 파열 1예

Rupture of Innominate Artery After the Anterior Mediastinal Tracheotomy : A Case Report

  • 김승우 (서울보훈병원 이비인후과) ;
  • 김춘동 (서울보훈병원 이비인후과) ;
  • 김정민 (서울보훈병원 이비인후과) ;
  • 사대진 (서울보훈병원 이비인후과)
  • Kim, Seung-Woo (Department of Otolaryngology-Head and Neck Surgery Seoul Veterans Hospital) ;
  • Kim, Choon-Dong (Department of Otolaryngology-Head and Neck Surgery Seoul Veterans Hospital) ;
  • Kim, Jung-Min (Department of Otolaryngology-Head and Neck Surgery Seoul Veterans Hospital) ;
  • Sah, Dae-Jin (Department of Otolaryngology-Head and Neck Surgery Seoul Veterans Hospital)
  • 발행 : 2011.05.27

초록

The anterior mediastinal tracheotomy(AMT) facilitates resection of stomal recurrence after total laryngectomy and tumors involving the cervicothoracic trachea and esophagus. An 81-year-old-man came to our clinic due to the progressive dyspnea during three months. He received the total laryngectomy five years ago. We diagnosed as Sisson type I stomal recurrence and then performed the wide excision, both selective neck dissection, sternal manubrium resection and AMT. Before surgery, we planned the pectoralis major myocutaneous flap. Unluckily we could not fulfill this procedure because of patient's medical status during anesthesia. The tracheocutaneous fistula was observed in the second postoperative day. He expired due to the huge bleeding from the wound. When AMT is performed, exact manipulation of major vessels and adequate flap are mandatory these elevate the feasibility of AMT.

키워드

참고문헌

  1. Orringer MB. Anterior mediastinal tracheostomy. J Thorac Cardiovasc Surg. 1979;78:850-859.
  2. Conti M, Benhamed L, Mortuaire G, Chevalier D, Pinçon C, Wurtz A. Indications and Results of Anterior Mediastinal Tracheostomy for Malignancies. Ann Thorac Surg. 2010;89:1588-1596. https://doi.org/10.1016/j.athoracsur.2010.01.044
  3. Zhao H, Ren J, Zhuo X, Ye H, Zou J, Liu S. Stomal Recurrence After Total Laryngectomy A Clinicopathological Multivariate Analysis. Am J Clin Oncol. 2009;32:154-157. https://doi.org/10.1097/COC.0b013e31817e6ee3
  4. Ampil F, Ghali G, Caldito G, Baluna R. Post-laryngectomy stomal cancer recurrences, re-treatment decisions and outcomes: Case series. Journal of Cranio-Maxillofacial Surgery. 2009; 37:349-351. https://doi.org/10.1016/j.jcms.2008.12.006
  5. Imauchi Y, Ito K, Takasago E, Nibu K, Sugasawa M, Ichimura K. Stomal recurrence after total laryngectomy for squamous cell carcinoma of the larynx. Otolaryngol Head Neck Surg. 2002;126:63-66. https://doi.org/10.1067/mhn.2002.121515
  6. Yamamoto Y, Midehiko M, Fukuda S, Furuta Y, Yagi K, Okushiba S. Reconstruction following total laryngopharyngoesophagectomy and extensive resection of the superior mediastinum. Plast Reconstr Surg. 1997;99:506-510. https://doi.org/10.1097/00006534-199702000-00028
  7. Lore Jr JM, Szymula NJ. Superior mediastinal exposure. Arch Otolaryngol. 1980;106:6-7. https://doi.org/10.1001/archotol.1980.00790250008002
  8. Merav AD. The role of mediastinoscopy and anterior mediastinotomy in determining operability of lung cacer: A review of publiccshed questions and answers. Cancer Inv. 1991;9:439-442. https://doi.org/10.3109/07357909109084642
  9. Sisson GA. Mediastinal dissection-resectability and curability of stomal recurrence after total laryngectomy. Auris Nasus Larynx. 1985;12(suppl 2):61-66. https://doi.org/10.1016/S0385-8146(85)80031-6
  10. Orringer MB. Anterior mediastinal tracheostomy with and without cervical exenteration. Ann Thorac Surg. 1999;67:591. https://doi.org/10.1016/S0003-4975(98)01267-3
  11. Gomez-Caro A, Gimferrer JM, Macchiarini M. Technique to Avoid Innominate Artery Ligation and Perform an Anterior Mediastinal Tracheostomy for Residual Trachea of Less Than 5cm. Ann Thorac Surg. 2007;84:1777-1779. https://doi.org/10.1016/j.athoracsur.2007.08.002
  12. McCarthy CM, Kraus DH, Cordeiro PG. Tracheostomal and Cervical Esophageal Reconstruction with Combined Deltopectoral Flap and Microvascular Free Jejunal Transfer after Central Neck Exenteration. Plast. Reconstr. Surg. 2005;115:1304. https://doi.org/10.1097/01.PRS.0000156916.82294.98