Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.
Tracheotomy and endotracheal intubation continues to be most common cause for tracheal stenosis and management involves tracheal resection and reapproximation. In this case, the patient presented with a history of multiple cardiac surgical procedures. She undergone a tracheostomy and developed recent symptoms of stridor. Imaging studies demonstrated a typical tracheostomy and stromal stricture. Surgical management involved tracheal resection and primary anastomosis. This video details the specifics for a tracheal resection from incision to closure.
Supine, shoulders elevated, and neck extended.
Curved incision in the anterior neck through previous tracheostomy scar.
The incision is closed with absorbable suture and glue. A soft compression dressing is applied. Patients are allowed to weight-bear as tolerated. Assistive devices are offered to patients post-operatively but typically are not needed. Patients are instructed to avoid unnecessary ambulation and elevate the leg as much as possible during the first three weeks post-operatively. This will help limit swelling of the lower extremity and any issues with wound healing. Diabetic and obese patients may require additional interrupted nylon sutures to support their incision. These are removed at two weeks post-operatively. At three weeks post-operatively, patients may be referred to physical therapy to address any issues with edema, scar, ankle ROM, strength and ambulation. At two months post-operatively, they are typically released to all activities.
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