Reconstruction of the trachea: experience in 100 consecutive cases

Abstract

Anatomic mobilization of the trachea permits resection of one half or more with primary anastomosis. An anterior approach by a cervical or cervicomediastinal route utilizes cervical flexion to devolve the larynx and tracheal mobilization with preservation of the lateral blood supply. The transthoracic route is employed for lower tracheal lesions. Over 100 tracheal resections have been done using these methods of direct reconstruction. Eighty four patients suffered from benign strictures, 79 resulting from intubation injuries. Eleven primary tracheal tumors and five secondary tumors are included. The majority of lesions following intubation occurred at the level of the cuff. It was possible to repair 78 of the 84 stenotic lesions through a cervical or cervicomediastinal approach. Seventy three of the 84 patients with inflammatory lesions obtained an excellent or good functional and anatomic result. Nine of 11 patients with primary neoplasms who underwent reconstruction are alive and without known disease. There were five early postoperative deaths in these 100 consecutive patients who underwent tracheal reconstruction.