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Tracheobronchial Surgery: Experience of The Thoracic Surgery Department in Fez- Morocco.

Author: Marouane Lakranbi , Hicham Harmouchi, Fatima Zahra Ammor, Laila Belliraj, Fatima Zahra Lamouime, Yassine Ouadnouni, Mohamed Smahi

Category: JMSR Surgery


Introduction: Tracheobronchial resections with anastomosis are not very common. They are mostly indicated in post-intubation tracheal stenosis and tracheal tumors (80% of which are malignant). As for bronchoplastic pulmonary resections, they are mainly applied to bronchopulmonary cancer. The goal of this surgery is to allow a carcinological resection with an optimal conservation of a good respiratory function. The purpose of this study isto discussthe indications, surgical techniques and prognosis of tracheal resections and bronchoplasty. Materials and Methods: It is a retrospective study including 30 patients who underwent tracheobronchial resection with anastomosis over 10 years (2010-2019) in the thoracic surgery department at Hassan IId University hospital in Fez-Morocco. Results: A total of 30 patients were operated on, divided in 2 groups: the first group with 20 cases of tracheal disease and the second group with 10 cases of bronchial disorder. The 1st group includes 11 cases of post-intubation tracheal stenosis and 9 cases of tracheal tumors. The surgical approach was mainly through a cervical approach with cervicotomy in 8 cases. End-to-end tracheal anastomosis was performed in 13 patients. Two deaths were reported: the first patient died on day 4 from cataclysmic hemothorax and the second 8 months after surgery by complications related to post-radiation tracheal stenosis. In the second group, the bronchial condition consisted of carcinoid tumors in 80% of cases (8 patients). Posterolateral thoracotomy was performed in all patients. They initially underwent lung resection followed by bronchoplasty. The post-operative course was uneventful. Conclusion: The prognosis of tracheobronchial surgery is influenced by patient selection and the mastering of the tracheal surgical techniques. For bronchoplastic surgery, the fresh mount study of the sections plays a major role.

Keywords: Anastomosis, Bronchi, Thoracic Surgery, Trachea, Morocco


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