Leonardo Duranti*, Rolli Luigi and Pardolesi A
Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, ItalyFulltext PDF
Background: The trachea is an anatomical structures of 10 cm to 12 cm of length in adults, which could appear just a simple conduit that brings the air to the lungs, but it is a very complex organ with a lot of functions and is supplied by many arterial branches arising from inferior thyroid artery, bronchial, intercostal arteries or direct branches from discending aorta, that create a vascular reticulum entering inside and feeding the ciliated pseudostratified columnar epithelium.Methods: The literature search has been made by using as a keywords “Tracheal tumors”, “Trachea surgery”, “Carina surgery”, “Engineered trachea”. We selected 74 articles from 15191 papers.Results: According to the literature search, we can say that, because of its own structure, it’s not simple to resect and reconstruct the trachea by direct end to end anastomosis, especially for more than 50% of its length and it cannot be easily replaced or transplanted. Although surgery is not the only possible therapy, the radiotherapy and the endoscopic treatments are so far from guarantee an adequate survival, and they are usually employed as adjuvant therapies after surgery or they are reserved to non-surgical patients for medical problems or oncological criteria.Conclusion: To overcome the surgical limits in direct reconstruction, have been developed different autogenic or allogenic grafts and nowadays there are different vascularized biocompatible scaffolds till the tissue engineered neotrachea, but more studies are still needed to standardize a valid reconstructive system for tracheal major resections or transplantation.
Tracheal tumors; Trachea surgery; Carina surgery; Engineered trachea
Duranti L, Luigi R, Pardolesi A. Surgery in Tracheal Tumors. Clin Surg. 2018; 3: 2251.