Tracheal resection and anastomosis after traumatic tracheal stenosis in a horse.
Authors: Barnett Timothy P, Hawkes Claire S, Dixon Padraic M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Traumatic tracheal stenosis presents a significant surgical challenge in equine practice, yet definitive anatomical repair through resection and anastomosis remains uncommonly reported. In this case, a 9-year-old Warmblood gelding with single-ring tracheal stenosis underwent endoscopic assessment followed by surgical resection with end-to-end anastomosis of the adjacent tracheal rings, ultimately achieving complete healing and return to full athletic performance despite considerable perioperative complications. Although a unilateral mucosal web formed during the healing process and required subsequent transendoscopic laser ablation, and iatrogenic left recurrent laryngeal nerve injury necessitated later laryngoplasty to address laryngeal hemiplegia, the technique successfully re-established a patent tracheal lumen. For equine practitioners managing chronic airway obstruction secondary to trauma, this case demonstrates that direct surgical correction can offer a viable alternative to conservative management or permanent tracheostomy, though surgeons must anticipate the real risks of iatrogenic nerve damage and post-anastomotic stenosis formation. The authors' experience suggests that careful patient selection, meticulous surgical technique, and willingness to manage secondary complications through multimodal intervention can yield functionally excellent outcomes even in complex airway cases.
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Practical Takeaways
- •Tracheal resection and anastomosis is a viable surgical option for managing traumatic tracheal stenosis, even when complications occur
- •Post-operative mucosal web formation may occur and can be managed with transendoscopic laser surgery if it causes clinical signs
- •Careful surgical technique and nerve identification are critical during tracheal anastomosis to minimize recurrent laryngeal nerve damage; if damage occurs, laryngoplasty can still achieve functional recovery
Key Findings
- •Tracheal resection and end-to-end anastomosis successfully restored tracheal lumen in a case of single-ring traumatic stenosis
- •A unilateral partial mucosal stenosis web formed post-operatively but was successfully removed by transendoscopic laser surgery
- •Left recurrent laryngeal nerve damage occurred during anastomosis, causing laryngeal hemiplegia that was treated with laryngoplasty
- •The horse returned to previous level of athletic work despite major intra-operative and post-operative complications