在气管切开标准的吻合口狭窄和气管切除修复

                               
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Tracheotomy and endotracheal intubation continues to be most common cause for tracheal stenosis and management involves tracheal resection and reapproximation. In this case, the patient presented with a history of multiple cardiac surgical procedures. She undergone a tracheostomy and developed recent symptoms of stridor. Imaging studies demonstrated a typical tracheostomy and stromal stricture. Surgical management involved tracheal resection and primary anastomosis. This video details the specifics for a tracheal resection from incision to closure.  

Position
Supine, shoulders elevated, and neck extended.

Incision
Curved incision in the anterior neck through previous tracheostomy scar.

Table of Contents (Standard)
00:25 Incision
00:33 Superficial Dissection to Elevate Subplatysmal Flaps
01:31 Subplatysmal Dissection
02:53 Dividing the Infrahoyd Muscles along the Midline  
03:26 Dividing the Thyroid Isthmus
03:40 Identifying the Tracheal Stricture and Mobilizing Away from Tracheal Wall
03:59 Finger Dissection along the Trachea
04:11 Anterior Traction Suture and Exam of Tracheal Stricture and Adjacent Landmarks
04:30 Partial Incision Proximal to the Stricture
04:59 Anterior Traction Sutures on the Proximal Airway and Stricture
05:30 Retracting the Endotracheal Tube into the Proximal Trachea
05:44 Partial Incision Distal to the Stricture
06:05 Anterior Traction Sutures on the Distal Airway
06:28 Insertion of Cross Field Ventilation Tubing
06:35 Elevating the Stricture through Dividing the Posterior Membranous Airway
07:03 Examination of Excised Tracheal Stricture
07:09 Additional Traction Sutures on the Proximal Airway
07:22 Closing the Posterior Membranous Airway with 4-0 PDS
08:32 Closing the Partial Anterior Cartilaginous Airway with 3-0 Vicryl
09:21 Removing the Cross Field Tubing and Advancing the Endotracheal Tube
09:47 Securing the Anterior Sutures of the Cartilaginous Airway
10:06 Testing Trachea Repair under Saline for Air Leaks
Diagnostic Flexible Bronchoscopy and Direct Visualization of the Anastomosis (Not Shown)
10:11 Sewing the Infrahoyd Muscles to the An  terior Aspect of the Airway
11:07 Closing Platysma with a Running Suture
11:57 Subcuticular Closure
13:29 Guardian Stitch between the Chin and Anterior Chest Overlying the Sternal Manubrial Junction
14:02 Credits