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Lung incarceration after anterior mediastinal tracheostomy
Abel Gómez-Caro1, Josep Maria Gimferrer, Laureano Molins
1General Thoracic Surgery Department, Hospital Clinic, University of Barcelona, Barcelona, Spain. gomezcar@clinic.ub.es
The Annals of Thoracic Surgery
|April 24, 2013
Summary
A complex anterior mediastinal tracheostomy repair was performed for stoma ulceration. A subsequent lung herniation was successfully managed with surgical repair and a Gore-Tex prosthesis.
Area of Science:
- Thoracic surgery
- Reconstructive surgery
- Surgical oncology
Background:
- A 63-year-old male patient presented with postradiotherapy stoma ulceration.
- The ulceration involved the trachea, cervical vessels, and pharynx, necessitating complex anterior mediastinal tracheostomy.
Observation:
- An anterior chest wall defect was reconstructed using a myocutaneous pectoral flap.
- Postoperatively, a right upper lobe lung herniation through the chest wall defect was observed on postoperative day 7.
Findings:
- Surgical repair involved a right thoracotomy to reposition the herniated lung.
- The chest wall defect was successfully reconstructed using an expanded polytetrafluoroethylene (Gore-Tex) prosthesis.
Implications:
- This case highlights a rare complication of anterior mediastinal reconstruction.
- Effective management involved a multi-stage surgical approach for lung herniation and chest wall defect closure.
- Successful repair and prosthesis use are crucial for patient recovery in complex thoracic reconstructions.
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