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10.5606/tgkdc.dergisi.2020.18144
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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