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KMID : 0371319670090030157
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Journal of the Korean Surgical Society
1967 Volume.9 No. 3 p.157 ~ p.162
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A Case of Traumatic Rupture of Cervical Trachea
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李弘均/Lee, Hong kyun
尹元老/金仁哲/金基獻/Yoon, Won Rho/Kim, In Chul/Kim, Ki Hun
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Abstract
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The reconstructive surgery of the tracheobronchial tree has been interested in management of tracheobronchial injuries caused by gradually increasing traffic accidents and resection of benign or malignant tracheal tumors, but yet the effective tracheal reconstruction for its defect has not been established as well as transplantation or prosthesis of the bone & blood vessel.
The thirty-one yeas old driver admitted to St. Mary hospital on 3rd oct, 1965, complaining of dyspnea, cough, hemoptysis and limitation of motion of the lower extremities due to traffic accidents. On admission, emergency tracheostomy was performed through ruptured site of cervical trachea (tracheal cartilage 2&3). On 24th Jan, 1966, First tracheoplasty was undertaken by removal of the second and third granulated-and torn tracheal cartilages, and end to end direct anastomosis of the 1st & 4 th tracheal rings with catgut. On postoperative third weeks, the anastomosis site was found to be constricted and stenotic by granulation. Therefore, on 23rd May, 1966, the stenotic ring of the cervical trachea was resected and direct end to endre anastomosis of the cricoid and sith tracheal cartilage was performed with mediastinal mobilization of trachea and then. the tracheal defect meassured about 4.Ocm in length. The tracheostomy was made at three ring lower the amastomosis site. Postoperative course was excellent with complete reliefs of hoarseness and respiratory difficulty.
Several points that should be regard to primary anastomosis of traumatic tracheal rupture are as follows,
1) The direct end to end anastomosis should be made without interplaced soft tissue.
2) The suture materials used to anastomose is best of stainless-steel at cartilage portion and catgut at membranons portion.
3) The tracheostomy should be made three cartilage lower from suture site for avoiding infection. The pertinent literature was reviewed, together with the discussion of the several problems of the plastic reconstruction of the tracheal defect.
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