The operation of choice for closure of large defects of the anterior wall of the trachea.
Annotatsiya
While it is impossible to radically eliminate a pathological substrate in the wall of the trachea, its clearance should long be formed on a silicon T-shaped stent protector. It is less traumatic, simplify the monitoring of endotracheal processes and allow us to rehabilitate 85-90% of patients, who are unable to undergo radical surgery because of the high risk of complications. We studied the results of surgical treatment of 102 patients with defects of the anterior wall of the upper third of the trachea, suspender division of the larynx and soft tissues of the neck after laryngotracheostomy or tracheostomy. 92 patients with defects of the anterior wall of the trachea and soft tissues of the size from 1.0 cm to 2.0 cm wide and 2.0 cm to 4.0 cm in height (Fig. 1), while the depth of the defect exceeding 8 mm, and the rack is formed the lumen of the airway in the area of plastics narrowing without the presence of a T-shaped stent, underwent a local three-layer or four-layer skin-muscle plasty of the defect. Ten patients with extensive defects of the anterior-lateral walls of the trachea and the distal part of the larynx, underwent reconstructive surgeries using microsurgical technics. With the size of the defect of the trachea up to 3x4 cm, a sufficient depth of the lumen of the trachea corresponding to the clearance above and below the stoma, the common axis of the trachea and the distal part of the larynx without displacement and deformation of the lumen the operation of choice is a skin-muscle plasty of a defect with the substitution of local tissues (Fig. 2).