Tracheomalacia as Complication of Stenting for Esophageal Injury After Transsternal Approach to High Thoracic Vertebral Metastasis

doi:10.1016/j.wneu.2019.01.149

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學研究所 > 期刊論文 > Item 310902500/19905

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/19905

Title:	Tracheomalacia as Complication of Stenting for Esophageal Injury After Transsternal Approach to High Thoracic Vertebral Metastasis
Authors:	Lin, C.-H. Liao, C.-H.
Contributors:	圖書館
Date:	2019-03
Issue Date:	2019-03-15T03:11:37Z (UTC)
ISSN:	18788750
Abstract:	Background: Esophageal injury is a severe surgical complication of a transsternal approach to high thoracic vertebral metastasis, which can result in mediastinitis and life-threatening consequences. A covered stent can be placed in the esophagus to prevent mediastinal leakage. However, tracheomalacia is a rare complication following esophageal stenting. Case Description: A 56-year-old man had a pathologic fracture of the T3 vertebral body with spinal cord compression, myelopathy, and neurogenic bladder. An esophageal injury was noticed during the transsternal approach. Immediate suture repair, drainage tube placement, and subsequent esophageal stenting were carried out. One month after discharge, the endoscopic examination revealed nonhealing of the esophagus, and a new covered stent was replaced. Episodes of severe stridor and dyspnea led to the patient being sent to the emergency department. Computed tomography scan of the chest revealed a focal collapse of the trachea at the thoracic inlet, and tracheomalacia was suspected. The covered stent was removed, despite nonhealing of the esophagus. His stridor, dyspnea, and constant coughing subsided afterwards. The endoscopic examination at 3 months after stent removal showed complete healing of the esophagus. Conclusions: Esophageal stenting can be used to prevent mediastinal leakage due to esophageal injury in the transsternal approach for high thoracic vertebral metastasis, but the stent might be a cause of tracheomalacia. Stent removal should be considered if upper airway obstruction occurs. Awareness of the radial force of the stent, esophageal composition (e.g., status post suture repair), and esophageal diameter must be considered for optimal stent tolerance to avoid complications. © 2019 Elsevier Inc.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/19905
Relation:	World Neurosurgery Volume 125, May 2019, Pages 67-71
Appears in Collections:	[醫學研究所] 期刊論文

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