Surgical management of tracheal anastomosis failure and risk of arterial bleeding

Parshin VD, Pushkin SYu, Akopov AL, Parshin AV, Kovalev MG, Abashkin NYu, Parshin VV. Surgical management of tracheal anastomosis failure and risk of arterial bleeding. Pirogov Russian Journal of Surgery. 2023;(9):20‑33. (In Russ.)
https://doi.org/10.17116/hirurgia202309120

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To determine the optimal algorithm for tracheal anastomotic insufficiency and prevention of arterial bleeding.

MATERIAL AND METHODS

We present 2 patients with defects of tracheal anastomosis after tracheal resection and divergence of tracheal edges. We primarily analyzed appropriate emergency care and prevention of subsequent severe complications such as arterial bleeding and respiratory insufficiency.

CONCLUSION

Tracheostomy may be preferable for complete late tracheal anastomotic insufficiency to restore breathing. However, surgery should be accompanied by prevention of arterial bleeding. Isolation of damaged area, particularly tracheostomy tube, from the mediastinum by well-vascularized tissues can prevent bleeding from major vessels (for example, innominate artery). Follow-up is unreasonable due to worsening of clinical situation, risk of hemorrhagic complications and fatal outcomes. General satisfactory clinical status of the patient is not of matter. Repeated tracheal anastomosis is justified only for early insufficiency, i.e. within 2-3 days when postoperative inflammation is mild.

Keywords:

cicatricial tracheal stenosis

tracheal cancer

tracheal resection with anastomosis

postoperative complications

infectious complications

tracheal anastomosis failure

bleeding

Authors:

Parshin V.D.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases;
Russian Medical Academy of Postgraduate Education

ORCID: 0000-0002-0104-481X

Pushkin S.Yu.

Samara State Medical University

ORCID: 0000-0003-2206-6679

Akopov A.L.

Pavlov St. Petersburg First State Medical University

ORCID: 0000-0001-8698-7018

Parshin A.V.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-1804-3386

Kovalev M.G.

Pavlov St. Petersburg First State Medical University

ORCID: 0000-0002-0011-3510

Abashkin N.Yu.

Samara State Medical University

ORCID: 0000-0003-1101-3563

Parshin V.V.

Sechenov First Moscow State Medical University

ORCID: 0000-0002-6897-5715

Received:

30.05.2023

Accepted:

19.06.2023

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References:

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