Surgery of the trachea
Disease of the windpipe (= trachea) is usually associated with severe limitations and suffering for those affected. Mostly this is respiratory distress, which leads to a considerable reduction in performance and also to immobilisation.
The following diseases can lead to a narrowing of the trachea:
- Enlargement of the thyroid gland - especially when the thyroid gland moves into the chest - can lead to compression of the windpipe and thus to stridor and shortness of breath.
- Narrowing of the windpipe due to both benign and malignant tumours.
- Narrowing of the windpipe due to stenoses after tracheotomy.
- Idiopathic unification of the trachea.
- Tracheomalacia (= instability of the trachea)
The treatment of these diseases depends on the type of constriction, but also on its location. For example, a compression of the windpipe due to an enlargement of the thyroid gland can usually be eliminated and thus cured by a thyroid resection.
Several options are available for the treatment of tracheal stenosis of other causes:
- Interventional, endoscopic ablation by the pulmonology department in our clinic. These include the insertion of stents (tubes made of silicone and/or metal) to bridge constrictions as well as the removal of foreign tissue by means of laser and/or cryogenic (= icing) technology
- Tracheal resection. The trachea can be resected up to a length of 4-6 cm. Continuity is restored by anastomosis. This is a relatively minor operation, after which the patient remains in hospital for about 1 week. These operations are performed in the surgical clinic of our hospital.
Interventional, endoscopic ablations can be used, for example, for idiopathic and tumour-related stenoses. The interventional insertion of tracheal stents also allows the airways to be kept open. These stents also stabilise the trachea, so that this procedure can also be used for tracheomalacia.
The location of the lesion in the trachea is important for this option. If the lesion in the trachea is too close to the larynx, these stents cannot be inserted because they cannot be placed or anchored.
Tracheal resection is a very good therapeutic option for all lesions of the trachea. A classic indication is tracheal stenosis after tracheotomy, even the already mentioned idiopathic stenosis can be treated in this way.
The advantage of the operation is the fact that a permanent freedom from symptoms can be achieved.
However, the location of the stenosis or tumour is also important for tracheal resection. Lesions that lie directly under the larynx or involve the larynx represent a particular challenge (high tracheal stenosis). In this case, good preoperative diagnostics is required, which is carried out by our pulmonological, - and ENT medical department.
The decision to operate is made in an interdisciplinary consultation. Operations involving the larynx are performed in cooperation with the head physician of our ENT department.