ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Successful tracheal necrosis management using a pedicle pectoralis flap: A case report
Negar Eftekhar1, Anahita Borjian2, Shahab Rafieian1, Mohammad Amin Borjian2, Mehdi Abbasi Sahebi1
1Department of Thoracic Surgery, Tehran University of Medical Science, Tehran, Iran
2Tehran University of Medical Science, Cancer Institute, Tehran, Iran
DOI : 10.5606/tgkdc.dergisi.2020.18144
Thyroidectomy is considered an overall low-risk procedure. However, severe life-threatening complications, including tracheal necrosis may occur postoperatively. A 45-year-old male patient was referred to our clinic for papillary thyroid carcinoma surgery. The patient had mediastinitis signs and symptoms seven days after total thyroidectomy. Subsequent imaging demonstrated air leak and with mediastinitis as the primary diagnosis, and the patient underwent reoperation. During the operation, four necrotic tracheal rings were found to be the source of air leak. Due to tissue inflammation and infection, neither primary repair with tracheal resection and anastomosis, nor strap muscle plugging procedure were feasible. Therefore, a pedicle flap derived from the right pectoralis major muscle was transferred to the necrotic trachea. The patient"s clinical condition improved after the operation and subsequent bronchoscopies confirmed healing of trachea. During six-month follow-up, no complications were observed. In conclusion, the technique discussed in the current report shows promising outcomes for reconstructing large tracheal defects in inflammatory conditions where primary repair techniques are not suitable.
Keywords : Pectoralis muscle, thyroidectomy, trachea
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