Surgical Management of Tracheal Tumors
Section snippets
Patients and Methods
Between 1975 and 1994, 22 patients with primary neoplasms of the proximal tracheobronchial tree were treated by resection. There were 13 men and 9 women, ranging in age from 26 to 76 years.
The trachea was involved in all instances. The neoplasm extended into the left bronchus in one patient and invaded the carina and the right bronchus in one. In one patient the tumor arose from the right tracheal wall between the origin of an anomalous tracheal bronchus and the right main bronchus.
Symptoms and
Results
There was one operative death (patient 2). Follow-up has been maintained on all surviving patients. Of the 12 survivors with adenoid cystic carcinoma, 1 patient died of myocardial infarction without recurrent tumor 3 years after the operation, 2 patients died of metastatic spread 5 years 2 months and 7 years after the operation (both did not receive postoperative radiotherapy); and 9 patients are living without tumor (all irradiated) from 4 years to 12 years 2 months after the resection.
Of the
Comment
Delays in diagnosis of tracheal tumors occur commonly because the large lumen of the trachea prevents early occlusion. Belsey [1] determined that 75% of the tracheal lumen must be occluded before symptoms occur. In addition, nonspecific respiratory symptoms are easily confused with other pulmonary diseases. Several of our patients were treated by their family physicians for supposed infection or asthma, with delay of their clinical workup. Some of our patients were so managed for up to 6 months
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