Diagnosis and treatment of tracheal and bronchial tumors

  Diagnosis: 1. History of benign tracheal tumors (including squamous cell papilloma, osteochondroma, lipoma, hemangioma, fibroma, and smooth muscle tumor) and malignant tumors (squamous carcinoma, adenoid cystic carcinoma), most of which have been misdiagnosed as “asthma” and a history of pulmonary atelectasis.  2.Signs of croup can be heard, or hypopnea can be heard on the side of pulmonary asplenia.  3.Auxiliary examination ①X-ray examination. Chest x-ray, tracheal tomography can be seen as a shadow of a mass in the trachea.  ②ct scan examination. It can show the tracheal tumor site, tumor size and the relationship between tumor and surrounding tissues.  ③fiber bronchoscopy. It can clarify the location and size of the lesion, and biopsy is feasible.  Treatment: 1.Circumferential tracheal resection and tracheal end-to-end anastomosis tracheal resection should not exceed 6cm~6.6cm at the longest, and the head should be fixed low for about 10~14 days after surgery, and the head should be raised only after 3 months.  2, tracheal rung resection and reconstruction ① One side of the whole lung and the rung is resected, and the trachea is anastomosed with the opposite side of the main bronchus.  ②Romnithotomy, anastomosis of trachea with the opposite end of the right main trachea, and end-lateral anastomosis of the left main bronchus with the right middle bronchus.  (iii) rongectomy and right upper lobe resection, trachea with right main bronchus anastomosis opposite end and right middle bronchus anastomosis end to end.  ④Romphistoidectomy with lateral anastomosis of the right and left main bronchus followed by anastomosis with the broken end of the trachea.        (⑤Romnea resection, replacing the romnea with tantalum wire silicone tube, etc.  3.Local tracheal resection and reconstruction is mostly used for those with limited lesions and less involvement of the wall. After resection, the defect of the tracheal wall can be repaired with tipped bronchial flaps, pericardium, pleura, skin, fascia and other materials.  4. Tracheoscopic or tracheotomy tumor removal is used for benign tumors such as smooth muscle tumors. We make an incision at the tracheotomy, insert the endoscope through here and remove the tumor under direct endoscopic view with good results.  5. Artificial trachea is suitable for those with extensive tracheal resection and difficult to anastomosis at the opposite end.