Operative Therapy Of Trachea Or Carina Diseases In 60 Cases

[Objective] The aim of this report was to enhance technical level of operative therapy of Trachea or Carina diseases and make the therapy for this kind of patients more reasonable,standard and effective.[Methods] Through summarying and analyzing the relatively complete data of operative therapy of 60 patients with trachea or carina diseases from 3,1990 to 12,2005.[Result] There are all 60 patients: 43 males and 17 females, with age from 42 to 71, with a mean age of 64.4. Among these diseases, there are 25 patients with lung cancer encroached carina, 19 with primary tracheal tumors(7 with adenoid cystic carcinoma, 6 with squamous carcinoma, each 2 with adenocarcinoma,carcinoid and colloid carcinoma),11 with esophageal carcinoma encroached trachea, 2 with thyroid carcinoma encroached trachea, each 1 with mediastinum rhabdomyosarcoma,trachea tuberculosis stenosis and tracheacyst with partial tracheal wall defect .The modus operandis include: 3 patients with fenestration of trachea and simple tumor resection, 2 with unilat tracheal wall resection and plasty, 28 with tracheal ring resection end-to-end anastomosis,22 with carina resection and plasty , 3 with carina resection and reconstruction, 6 with incision of trachea and retention tracheal intubation after exploration.The after-operation results include: the rate of excision is 96.67%(58/60); the mortality is 3.33%(2/60); there are 14(22.33%) patients occurred arrhythmia,7(11.67%) occurred pulmonary atelectasis, 9(15%) occurred pulmonary infection, 2 occurred air leak; there are 6 patients needed mechanical ventilation after operation; there is 1 patient accept secondary operation.[Conclusion]⑴It's important to grasp the operation indication, eliminate metastasis preoperatively, get the message of the size,position,growth pattern,scope,histologic characteristics of the tumor, appraisal general state of health of the patient, make sure if the patient can withstand the operation and benefit from the operation.⑵ANA and respiratory tract administration is important guarantee of trachea surgery. To ensure air tube to be unobstructed and enough oxygen to exchange and to prevent from lack of oxygen and carbon dioxide accumulation are major task in ANA administration at surgery. It's emphasized that it essentiality for anesthetist to take part in the preoperative discussion.⑶The choice of modus...