전종격동 기관절개술 이후에 발생한 무명동맥 파열 1예

Rupture of Innominate Artery After the Anterior Mediastinal Tracheotomy :A Case Report

The anterior mediastinal tracheotomy(AMT) facilitates resection of stomal recurrence after total laryngecto-my and tumors involving the cervicothoracic trachea and esophagus. An 81-year-old-man came to our clinic due to the progressive dyspnea during three months. He received the total laryngectomy five years ago. We diagnosed as Sisson type I stomal recurrence and then performed the wide excision, both selective neck dis-section, sternal manubrium resection and AMT. Before surgery, we planned the pectoralis major myocutane-ous flap. Unluckily we could not fulfill this procedure because of patient’s medical status during anesthesia. The tracheocutaneous fistula was observed in the second postoperative day. He expired due to the huge bleed-ing from the wound. When AMT is performed, exact manipulation of major vessels and adequate flap are mandatory these elevate the feasibility of AMT.