TRACHEAL RESECTIONS

The trachea, or windpipe, starts in the neck and continues down behind the breastbone where it divides into two smaller pipes called the bronchi, which supply air to each lung. It is made up of connective tissue and rings of stiff cartilage which allows the trachea to expand as you breathe. Tracheal resections are done for those who have narrowing or constriction of the trachea in which breathing is made difficult.

Why would a tracheal resection be needed?

Tracheal resection surgery may be needed if the trachea becomes narrowed or constricted due to conditions that affect the function of the windpipe including airway blockages, cancerous and noncancerous tumours, and problems with the larynx. Often the need for surgery is brought about by damage or injury to the trachea by prolonged intubation (using a breathing tube for a long period of time), injury to the throat and infections such as tuberculosis.

How is this procedure done?

How the surgery will be done will depend on the reason for a tracheal resection. Surgery will depend on the severity of the blockage or constriction. Under general anaesthesia, Dr Scott will perform one of the following surgeries using minimally invasive techniques::

  • A laryngotracheal reconstruction - this surgery is done to rebuild and widen the trachea with pieces of cartilage from another area of the body, or from a donor.
  • A laryngotracheal resection and reanastomosis - this surgery may be done to remove a section of the trachea which may be damaged, and join the two ends thus shortening the trachea somewhat.
  • Tracheostomy - this procedure is done for severe cases in which a stoma (hole) is created in the front of the neck, through the trachea. Through this hole, a tube is inserted to allow air to flow thru creating an airway for breathing. This surgery may also be done as a way of removing lung secretions and excess mucus from the lungs.
  • Tracheobronchial airway stent - this surgery is done for conditions which have caused damage to the trachea in which it has collapsed. For such cases, a tracheal stent made from metal or silicone is placed at the site of collapse to help keep the airway open.

What can I expect after surgery?

Waking up from a tracheal resection surgery, you can expect the so called “neck stitch”, which is a stitch from the chin to the chest, for approximately 10 to 14 days. This stitch keeps the neck in a neck flexion position, to allow for adequate tracheal healing. You will be kept in the ICU for close observation and will be moved from ICU to your hospital room where you will be advised to stay for a further 3 to 5 days before you may go home.

Dr Scott will advise you on how to care for your incisions and how to treat the symptoms after surgery. Symptoms of swelling, muscle pain in the upper back and shoulders, fatigue, sleeping and appetite problems, constipation and chest pain near the chest bone are all normal after this type of surgery. It may take anything from 6-8 weeks for a full recovery, and he will be able to tell you when you may begin physical activity. You will be instructed to walk regularly and slowly increase your activity, as well as how to do breathing exercises to aid recovery.