Tracheal Resection

A tracheal resection is a surgical procedure performed to remove all or part of the windpipe. The windpipe is the tube that connects the voicebox to the lungs. The windpipe normally has C-shaped rings of cartilage within the wall to make it more rigid. Occasionally some of these rings may develop in a circular shape, like a ring, which means they will not grow at the same rate as the rest of the windpipe and sometimes there may be rings missing. Injury to the windpipe, which can be due to a breathing tube used during a stay on intensive care, can result in a ring of scar tissue developing in the wall of the windpipe.

Both benign as well as malignant (cancerous) tumors of the trachea can cause narrowing of the trachea as well. Narrowing of the windpipe can cause severe breathing difficulties, which can be life threatening, especially if a chest infection is also present. Tracheal resection is sometimes required to remove the area of narrowing.

Tracheal resection can be performed via the following methods: minimally-invasive (small incisions of 2–3 inches long / general anesthesia) or open-surgery (large incisions of 8-10 inches long / general anesthesia). Based on your specific medical condition, your doctor will choose the most appropriate method.

How to prepare for tracheal resection procedure

Prior to the procedure, your doctor and treatment team will explain to you what to expect before, during and after the procedure and potential risks of the procedure. Other recommendations include:

Talk to your doctor about

• All medications, herbal products and dietary supplements you are currently taking and ask for their recommendations about each.
• Radiation exposure, especially for those that are pregnant
• Any allergies to medicines, latex, tape, iodine, and anesthetic agents
• Any history of bleeding disorders
• Any body piercings on your neck, chest or abdomen

Other suggestions

• Eat a normal meal the evening before the procedure. However, do not eat, drink or chew anything after midnight before your procedure. If you must take medications, only take them with sips of water.
• Leave all jewelry at home
• Remove all makeup and nail polish
• Wear comfortable clothing when you come to the hospital.
• If you normally wear dentures, glasses, or hearing devices at home, plan to wear them during the procedure.

What to expect before tracheal resectionprocedure

To determine whether you need a tracheal resection, your doctor might perform a variety of tests, including:

Diagnostic tests and procedures

• Bronchoscopy
• Pulmonary function tests
• Computed tomography (CT scan)
• Magnetic resonance imaging (MRI)
• X-rays
• Voice evaluation test
• Positon-emission tomography (PET)

What to expect during tracheal resectionprocedure

A tracheal resection will typically take anywhere from 4 to 7 hours to complete. This procedure is typically performed in the cardiothoracic operating room (OR). Check with your doctor about the details of your procedure. In general, during an open-surgical tracheal resection:

• You will change into a hospital gown.
• A nurse will start the intravenous (IV) line in your arm which will administer medications and fluids during the procedure.
• Usually, your doctor will administer general anesthesia (make you feel sleepy).
• Once you are sedated, your doctor may insert a breathing tube through your throat into your lungs and connect you to a ventilator. This will breathe for you during surgery.
• The procedure requires the tracheal narrowing or tumor to be removed and the two ends of the trachea put back together.
• Once this is complete, your doctor will closely check to make everything is connected properly using a bronchoscope (scope with a camera).
• Once the procedure is complete, your doctor will work with the anesthesia team to remove the breathing tube

What to expect after tracheal resection procedure

After the surgery, you will be taken to the cardiothoracic intensive care unit (CTICU) for 5 to 7 days until the airway heals. Other recommendations include:

General guidelines

• Your incision sites will be checked often.
• Ambulation is started on the first or second day of surgery.
• Urine catheters and drainage tubes are removed after 24 to 72 hours.
• You can probably do your normal activities after the surgery. But you may need to take it easy first.
• Your doctor will give you instructions to follow during your recovery.