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  #1  
Old 03-24-2009, 11:21 PM
mind2reality mind2reality is offline
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Unhappy Tracheal Resection?

Hey you guys once again. I am sorry I haven't updated in a while like I said I would but here I am! Well, I never got to make it to my appointment on the 19th because they had to airlift me to chapel hill the night before because my breathing became so bad. I scared the local ER doc to death so he called Chapel Hill and demanded they come get me, lol.

Anyhow, I stayed in the hospital that night, had a CT Scan the next day like I was suppose to and saw my ENT doc. He said we would have to do open surgery immediately, probably within the next week or two. He gave me his private number to contact him before my next appointment so that we could schedule pre-op and all that stuff. He said I would probably have 2 or 3 surgeries within a 6 week period along with having a trach for 6 weeks also.

We still haven't decided what surgery we're gonna do, he wants to look closer and study the CT scan and then discuss it on the phone.

What I was wanting to ask was this. I've heard that tracheal resections are very successful and I was curious as to what it consisted of and the recovery time, etc. for an adult. I don't really know what one is and was curious. The doc did say that I'd have to stay 5 days after the surgery because I would have a trach, but I'm not sure what he wants to do. I just want to get the surgery done that will be the most successful. Anyhow, I would really appreciate any and all advice anyone can offer so that I can talk to my doc about it and actually 'know' what I'm talking about. Thanks!
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Born July 4th, 1983, at 28 weeks. Trached due to Tracheal Stenosis on August of 1983. Decanned on May 31st, 1989. Now back to it all over again.
**Dilation Surgery Performed on October 22nd, 2008. No Trach.**
**Tracheal Resection done and Trached again on May 13th, 2009. Hopeful for decan on June 4th.**
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  #2  
Old 03-25-2009, 09:49 AM
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JWorthington JWorthington is offline
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Thanks for the update. It sounds like you've been having quite a time of it.Sorry I have no advice about the surgery, it isn't something that features in our future. hopefully someone here can help, or you may look at the main tracheostomy.com website, there are a lot of descriptions of surgery on there. good luck
Julie
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  #3  
Old 03-25-2009, 12:08 PM
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saywhatyouwill saywhatyouwill is offline
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hi
from what i have read the resection is an established, common, and successful operation in adults. it's where they remove the part of the trachea that is causing the problem.
if you do a general internet search i think quite a few articles will come up.

hope you are feeling okay.
clare.
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Grade III SGS - emergency tracheotomy July 2007.
2 stage LTR July 09 - DECANNED 27.9.09

tracheomalacia (GONE!! Sept08)
partial agenesis of the corpus callosum
residual VSDs post-surgery but lung pressures normal (Nov08),

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Old 03-29-2009, 12:35 AM
mind2reality mind2reality is offline
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Thanks you guys for the replies. I've searched and scoured the internet asking what exactly a resection is, but have yet to find a site that actually describes what it is and the recovery/hospital stay time. Hopefully if I keep searching, I can find something sooner than later. Thanks!
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Born July 4th, 1983, at 28 weeks. Trached due to Tracheal Stenosis on August of 1983. Decanned on May 31st, 1989. Now back to it all over again.
**Dilation Surgery Performed on October 22nd, 2008. No Trach.**
**Tracheal Resection done and Trached again on May 13th, 2009. Hopeful for decan on June 4th.**
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  #5  
Old 03-29-2009, 03:32 AM
TommysDad TommysDad is offline
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I'm no ENT surgeon by any means, but I did some research on the Cricoid traceal reconstruction (CTR) a few years back as this was put on the table as a possibility for our son way back when. Is just like saywhatyouwill said. Think of it like a drier hose with a bad kink in the middle somewhere. ENT surgeon basically cuts out the damaged part and stretches the upper and lower good parts back together. The two halves seem to get surgical glue & stitches to hold them together as they heal. From the research I did about two years back, it does have good outcomes usually because surgeons aren't having to do the rib graft and there seems to be less problems with scar tissue around the site because there is no graft work and less scar tissue from previously failed LTPs. Bad part about this surgery from what I have researched is that 1: if it doesn't work, you have less trachea to work with, and once you have shortened the trachea, there's only so much they can remove. Plus, if it doesn't work, it's hard to rebuild trachea rings out of nothing or to create an entire trachea ring completely from rib graft work, but it has been done! Yes, with the LTP you risk the graft not taking, scar tissue, etc., but at least you still have trachea rings to work with. 2: recovery is harder from what I have researched and pictured in my mind. One medical journal article I remember reading stated that doctors seem to put patients into medically induced commas or under very deep sedation for about 10 days to make sure patient does not thrash around and rip apart the surgical site...the trachea.

There is one adult on here that I know of that has had the LTP more than once and the CTR. Maybe that person will come on here and give you some more insight.

But everything I have read about the LTP and CTR is that this is not something you want to let a doctor try out on you! This requires great skill, and if a surgeon doesn't have experience doing this surgery, I wouldn't let them near my airway (or my child's) with a ten foot pole! You've only got one airway! So do your research and choose wisely!

Also, CTR seems to only be for those patients with subglottic stenosis. Once ENT opened up our child's airway, the found his blockage to be at the vocal cord region. ENT quickly removed the CTR as an option because they would have had to cut out the vocal cord area and where would they have joined the two parts together, the false vocal cord area??? Not a good idea!
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  #6  
Old 03-29-2009, 11:39 AM
mind2reality mind2reality is offline
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Default thanks so much

Quote:
Originally Posted by TommysDad View Post
I'm no ENT surgeon by any means, but I did some research on the Cricoid traceal reconstruction (CTR) a few years back as this was put on the table as a possibility for our son way back when. Is just like saywhatyouwill said. Think of it like a drier hose with a bad kink in the middle somewhere. ENT surgeon basically cuts out the damaged part and stretches the upper and lower good parts back together. The two halves seem to get surgical glue & stitches to hold them together as they heal. From the research I did about two years back, it does have good outcomes usually because surgeons aren't having to do the rib graft and there seems to be less problems with scar tissue around the site because there is no graft work and less scar tissue from previously failed LTPs. Bad part about this surgery from what I have researched is that 1: if it doesn't work, you have less trachea to work with, and once you have shortened the trachea, there's only so much they can remove. Plus, if it doesn't work, it's hard to rebuild trachea rings out of nothing or to create an entire trachea ring completely from rib graft work, but it has been done! Yes, with the LTP you risk the graft not taking, scar tissue, etc., but at least you still have trachea rings to work with. 2: recovery is harder from what I have researched and pictured in my mind. One medical journal article I remember reading stated that doctors seem to put patients into medically induced commas or under very deep sedation for about 10 days to make sure patient does not thrash around and rip apart the surgical site...the trachea.

There is one adult on here that I know of that has had the LTP more than once and the CTR. Maybe that person will come on here and give you some more insight.

But everything I have read about the LTP and CTR is that this is not something you want to let a doctor try out on you! This requires great skill, and if a surgeon doesn't have experience doing this surgery, I wouldn't let them near my airway (or my child's) with a ten foot pole! You've only got one airway! So do your research and choose wisely!

Also, CTR seems to only be for those patients with subglottic stenosis. Once ENT opened up our child's airway, the found his blockage to be at the vocal cord region. ENT quickly removed the CTR as an option because they would have had to cut out the vocal cord area and where would they have joined the two parts together, the false vocal cord area??? Not a good idea!
Thanks so much for the indepth reply, I really appreciate it. After reading your post, I realize now that the tracheal resection isn't an option for me I have subglottic & glottic stenosis. In the upper part of my trachea and down at the vocal cords really close to them. I guess that's why they are talking about doing a stent and all that. I know they are going to do some sort of reconstruction but I don't think he's planning to actually cut out part of it and stitch together because it's so close to my vocal cords so I'm unsure now of what he has planned. I'm suppose to call him tomorrow, a day before my appointment, so that we can determine what I need to plan for when I go in for the appointment Tuesday. I don't know if he just wants me to come in for pre-op tuesday and stay the night, then have the surgery the next day. I guess that is why he wants to consult with me on the phone before I come. But hopefully any option we choose will be the right option. I think he has another doctor that is going to assist with the surgery that has alot of tracheal surgery experience. He has the experience too but I guess he just wants a second pair of hands just to be sure and safe. Thanks so much for your reply, that's exactly what I wanted to know. Now I know that it's not really an option considering my circumstances. I'm just trying to make a list now of what to ask my doctor when I talk/see him.
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Born July 4th, 1983, at 28 weeks. Trached due to Tracheal Stenosis on August of 1983. Decanned on May 31st, 1989. Now back to it all over again.
**Dilation Surgery Performed on October 22nd, 2008. No Trach.**
**Tracheal Resection done and Trached again on May 13th, 2009. Hopeful for decan on June 4th.**
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