Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall

The objective was to improve the results of treatment of patients with persistent defects of the anterior tracheal wall and soft tissues of the neck.Methods and materials. 220 patients with tracheal cicatrical stenosis were treated, of which 120 patients had defects of the anterior tracheal wall of...

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Main Authors: O. D. Eshonkhodjaev, Sh. N. Khudaybergenov, R. Ya. Hayaliev
Format: Article
Language:Russian
Published: Pavlov First Saint Petersburg State Medical University 2021-06-01
Series:Вестник хирургии имени И.И. Грекова
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Online Access:https://www.vestnik-grekova.ru/jour/article/view/1520
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author O. D. Eshonkhodjaev
Sh. N. Khudaybergenov
R. Ya. Hayaliev
author_facet O. D. Eshonkhodjaev
Sh. N. Khudaybergenov
R. Ya. Hayaliev
author_sort O. D. Eshonkhodjaev
collection DOAJ
description The objective was to improve the results of treatment of patients with persistent defects of the anterior tracheal wall and soft tissues of the neck.Methods and materials. 220 patients with tracheal cicatrical stenosis were treated, of which 120 patients had defects of the anterior tracheal wall of various sizes. In 70% of cases, PCT was postintubation/posttracheostomy. Men predominated – 89 (74.2 %), women – 31 (25.8 %). After a routine examination, including endoscopic examination, MSCT of the chest with the capture of the cervical region, and general clinical diagnostic methods, all patients underwent surgical treatment.Results. According to the nature of the elimination of the defect of the anterior tracheal wall, patients were divided into several groups. Both local plastic surgery and the elimination of the tracheal defect with the use of microsurgical techniques were used. Circular resection of the trachea with the elimination of the defect was performed in 5 cases. In 2 cases, in the presence of a large persistent defect of more than 6 cm in size, a composite pre-fabricated deltopectoral skin-fascial-cartilage flap was used.Conclusion. The choice of a method for eliminating a persistent open defect of the anterior tracheal wall is determined individually in each case, it depends on its size, the depth of the airway lumen, and the condition of the surrounding tissues. The use of displaced skin-fascial flaps on the vascular pedicle for closing the tracheal defect allows to restore the mucous membrane of the tracheal defect area without using the surrounding scar tissue and close the defect with a second flap without straining the edges of the wound.
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series Вестник хирургии имени И.И. Грекова
spelling doaj-art-27405a68d4fb4b20a5cdf0b1df8f4b3c2024-11-26T10:43:55ZrusPavlov First Saint Petersburg State Medical UniversityВестник хирургии имени И.И. Грекова0042-46252021-06-011801313910.24884/0042-4625-2021-180-1-31-391196Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wallO. D. Eshonkhodjaev0Sh. N. Khudaybergenov1R. Ya. Hayaliev2Republican specialized center of surgery named after academician V. VakhidovRepublican specialized center of surgery named after academician V. VakhidovRepublican specialized center of surgery named after academician V. VakhidovThe objective was to improve the results of treatment of patients with persistent defects of the anterior tracheal wall and soft tissues of the neck.Methods and materials. 220 patients with tracheal cicatrical stenosis were treated, of which 120 patients had defects of the anterior tracheal wall of various sizes. In 70% of cases, PCT was postintubation/posttracheostomy. Men predominated – 89 (74.2 %), women – 31 (25.8 %). After a routine examination, including endoscopic examination, MSCT of the chest with the capture of the cervical region, and general clinical diagnostic methods, all patients underwent surgical treatment.Results. According to the nature of the elimination of the defect of the anterior tracheal wall, patients were divided into several groups. Both local plastic surgery and the elimination of the tracheal defect with the use of microsurgical techniques were used. Circular resection of the trachea with the elimination of the defect was performed in 5 cases. In 2 cases, in the presence of a large persistent defect of more than 6 cm in size, a composite pre-fabricated deltopectoral skin-fascial-cartilage flap was used.Conclusion. The choice of a method for eliminating a persistent open defect of the anterior tracheal wall is determined individually in each case, it depends on its size, the depth of the airway lumen, and the condition of the surrounding tissues. The use of displaced skin-fascial flaps on the vascular pedicle for closing the tracheal defect allows to restore the mucous membrane of the tracheal defect area without using the surrounding scar tissue and close the defect with a second flap without straining the edges of the wound.https://www.vestnik-grekova.ru/jour/article/view/1520cicatrical stenosisdefects of the anterior tracheal wallplastydisplaced flaps
spellingShingle O. D. Eshonkhodjaev
Sh. N. Khudaybergenov
R. Ya. Hayaliev
Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
Вестник хирургии имени И.И. Грекова
cicatrical stenosis
defects of the anterior tracheal wall
plasty
displaced flaps
title Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
title_full Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
title_fullStr Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
title_full_unstemmed Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
title_short Multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
title_sort multidisciplinary approach to surgical treatment and rehabilitation of patients with defects of the anterior tracheal wall
topic cicatrical stenosis
defects of the anterior tracheal wall
plasty
displaced flaps
url https://www.vestnik-grekova.ru/jour/article/view/1520
work_keys_str_mv AT odeshonkhodjaev multidisciplinaryapproachtosurgicaltreatmentandrehabilitationofpatientswithdefectsoftheanteriortrachealwall
AT shnkhudaybergenov multidisciplinaryapproachtosurgicaltreatmentandrehabilitationofpatientswithdefectsoftheanteriortrachealwall
AT ryahayaliev multidisciplinaryapproachtosurgicaltreatmentandrehabilitationofpatientswithdefectsoftheanteriortrachealwall