Tracheal resection and reconstruction: indications, surgical procedure, and postoperative care
Tracheal resection and reconstruction are surgical procedures that are used to remove sections of the trachea (wind pipe) and rejoin the remaining portions. These procedures are performed on patients with disorders that affect the airways of the trachea and lungs, causing wheezing, shortness of breath, whistle noises while breathing and excessive mucus production. Also, they are performed to remove tumors from the trachea and to reopen a closed hole that is used for inserting a breathing tube (endotracheal tube). Patients who are having difficulty breathing may have to have a hole cut in their trachea (tracheotomy) and a breathing tube inserted. This procedure can cause damage to the trachea, resulting in inflammation and the formation of scar tissue that may cause the hole used for the breathing tube to close. Sometimes, a tracheal resection may be required in patients with thyroid tumors that become so large that they press against or grow into the trachea and obstruct the flow of air. Before a tracheal resection can be performed, there are several diagnostic tests that have to be performed so that the area of the trachea requiring surgery can be identified. The necessary tests will vary depending on the patient's condition, and may include chest X-rays, fluoroscopy and bronchoscopy (examination of the inside of the trachea), lung function tests, breathing tests and angiography (X-ray examination of blood vessels). The surgery involves making a horizontal cut in the trachea just beneath the affected area. A breathing tube is inserted into the hole. Next, the resection (removal of the affected area and rejoining of the remaining tissue) is performed and another breathing tube is inserted that extends from above to below the area where the surgery was performed. The first breathing tube is removed and the patient is sent to the recovery room. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
Differential effects of continuous versus intermittent suction on tracheal tissue
The trachea, or windpipe, must be suctioned sometimes for various medical reasons. This suctioning has been shown to cause tissue damage. Suctioning equipment and pressures have been studied in regards to tissue damage, but suctioning technique, either continuous or intermittent suctioning, has not been studied to see which is better in avoiding tracheal tissue damage. It is generally thought that intermittent suctioning avoids the tissue damage that continuous suctioning may cause. Animals were used in this study of the different techniques because extensive tissue examination was required. Twelve animals were studied, including two that were not suctioned (controls), five receiving intermittent suctioning, and five receiving constant suctioning. The animals were killed at the end of the experiment and tracheal tissue samples were taken and examined. Results revealed that there was no statistical difference between the two suctioning methods in tracheal alterations, and that both methods caused significant tissue damage. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
Backflow in low-volume suction lines: the impact of pressure changes
Fluids in the tubing of dental suction devices may flow back into the patient's mouth under certain conditions. This could result in cross-contamination between patients. Researchers tested suction equipment both with a simulation model in the laboratory and with human subjects. For liquids to flow back through the tubing all the following had to take place: the patient's lips had to be closed around the suction tip; other units had to be in use at the same time at other stations, which caused rapid oscillations of liquid within the tube; and the tubing had to be higher than the level of the suction tip. This potential problem can be solved by positioning low-volume suction tubing below the level of the patient's mouth, substituting periodic use of the high-volume evacuator, or using single-use or disposable suction tubing.
Publication Name: Journal of the American Dental Association
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