Anterior Mediastinal Tracheostomy: Past, Present, and Future

Thorac Surg Clin. 2018 Aug;28(3):277-284. doi: 10.1016/j.thorsurg.2018.03.002.

Abstract

Anterior mediastinal tracheostomy (AMT) is established after division of the retrosternal trachea following resection of extended upper airway malignancies, stomal recurrences, or cervicomediastinal exenteration. AMT is occasionally performed for nonmalignant diseases. Starting in the 1980s, the use of a pectoralis major myocutaneous island flap reduced the mortality attributable to innominate artery rupture previously reported in historical series. Recent advances in the vascular reconstruction of supra-aortic trunks could allow future development of AMT as salvage surgery. On the other hand, construction of the stoma using free flap procedures and advances in chemoradiotherapy could simultaneously reduce the indication for AMT.

Keywords: Anterior mediastinal tracheostomy; Cervical exenteration; Laryngotracheal resection; Stomal recurrence; Tracheal surgery.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Brachiocephalic Trunk / injuries
  • Brachiocephalic Trunk / surgery*
  • Esophageal Neoplasms / surgery
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / adverse effects
  • Laryngectomy / methods
  • Larynx / surgery
  • Mediastinum / surgery*
  • Respiratory Tract Neoplasms / surgery*
  • Salvage Therapy
  • Surgical Flaps*
  • Surgical Stomas* / adverse effects
  • Trachea / surgery
  • Tracheal Neoplasms / surgery
  • Tracheostomy / adverse effects
  • Tracheostomy / history
  • Tracheostomy / methods*
  • Vascular System Injuries / etiology
  • Vascular System Injuries / prevention & control
  • Vascular System Injuries / surgery