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Complex tracheal lesion: correction with an intercostal muscle pedicle flap
Hylas Paiva da Costa Ferreira1, Carlos Alberto Almeida de Araújo, Jeancarlo Fernandes Cavalcante
1Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil. hylasferreira@gmail.com
Minimally invasive esophageal surgery for cancer can lead to rare complications. This case details managing a tracheal injury during minimally invasive esophagectomy, highlighting successful surgical repair.
Area of Science:
- Surgical Oncology
- Thoracic Surgery
- Gastrointestinal Surgery
Background:
- Minimally invasive esophagectomy is complex and carries risks like anastomotic dehiscence and fistulae.
- Epidermoid carcinoma of the esophagus requires surgical intervention, often involving extensive reconstruction.
Observation:
- A patient undergoing minimally invasive esophagectomy for distal esophageal cancer experienced an intraoperative left main bronchus injury.
- Postoperatively, the patient developed acute respiratory failure and significant air leak from thoracic drains and the cervical wound.
Findings:
- A second surgery revealed a large lesion in the membranous trachea, necessitating immediate correction.
- The tracheal lesion was successfully repaired using an intercostal muscle pedicle flap.
Implications:
- This case underscores the potential for severe airway complications during minimally invasive esophageal surgery.
- Successful management of such iatrogenic tracheal injuries is crucial for patient outcomes in complex thoracic procedures.
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