Tokuda Hospital Sofia

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For the 1st time in Bulgaria: Specialists constructed and implanted a trachea

14 august 2017

A team headed by Dr. Minchev, Head of the Thoracic Surgery at Acibadem City Clinic performed a 10-hour surgery of placing the unique autotransplant

A unique surgery – a trachea substitution of a whole organ made of autologous grafts constructed and implanted, was performed at Acibadem City Clinic Tokuda. The 10-hour intervention was carried out by teams of 4 specialties – in the fields of Chest Surgery, Plastic Surgery, Cardiac Surgery and ENT, guided by Dr. Tsvetan Minchev. He is Head of the Tokuda Thoracic Surgery Department, one of the leading structures in the country in surgical treatment of lung and thoracic diseases with a very large volume and complexity.

The surgeons created and placed an autotransplant – an organ made of its own tissues to replace the trachea affected by cancer and to now allow the patient breathe independently. For the first time in the world, surgeons have performed such a surgery where besides the construction of a new trachea, the malignant diseases of the esophagus, thyroid gland and parathyroid glands have been removed. The patient has also secondary changes caused by larynx cancer further affecting the trachea and the organs around it – the mediastinum, esophagus, lymph and other glands. The advancement of the cancer into the trachea gradually leads to an inability for normal breathing and a state incompatible with life.

“We managed to construct and implant the trachea with the help of tissue from the arm and cartilage from the patient's ribs. The surgery was a combination of several surgical stages where we removed other organs affected by the metastatic cancer. We have given the patient the chance to breathe independently”, Dr. Minchev explained the details of the unique surgery.

The autotransplant is 7 cm in length – like a normal trachea, and it was implanted with microscopic surgery using hand-feeding vessels connected to the mammary artery. Dr. Assen Kelchev from the Tokuda Cardiac Surgery Department joined in in the complex implantation and the vascular connection. Visiting surgeon Assoc. Prof. Margarita Kateva was actively involved in the autotransplant “creation”.

Surgeries of reconstruction and implantation of the trachea are very few worldwide, and the complexity and volume of surgery at Acibadem City Clinic Tokuda Hospital makes it unique on a global level. This method is also the only alternative in such cases, as immunosuppressive therapy after a possible full-donor tracheal transplantation increases the risk of cancer recurrence.

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Hospital location

51B "Nikola I. Vaptsarov" blvd. (if you drive, the entrance is from "At. Dukov" str.), "Hladilnika" distr., 1407 "Lozenets".

The hospital has a parking lot. The first 30 min. are free of charge, then a fee of 3 bgn/hours applies.

Public transport:
Buses: №88, 120
Shuttle bus: 32

Subway: Getting off at "James Bourchier" station, after that walking through "Lozenets" distr., or tram №10, taking off at "Nikola I. Vaptsarov" stop. or a bus №88, taking ff at "Tokuda Hospital" stop.

Map 

From the Central Railway Station

Bus line №305 getting off at "Romanian embassy" stop
From "Romanian embassy" stop – Bus line №120 getting off at "Tokuda Hospital" stop.
(after the traffic lights at "Atanas Dukov" str.

With a subway, from "Central Railway Station" station, getting off at "James Bourchier" station, after that walking through "Lozenets" distr., or tram №10, taking off at "Nikola I. Vaptsarov" stop. or a bus №88, taking ff at "Tokuda Hospital" stop.