[Tracheal resection and tracheal replacement]

Resection of cervical and thoracic tracheal segments is still the method of choice in treatment of strictures and tumors in operable patients. Consequences from long-term mechanical ventilation have become less frequent nowadays. En bloc resection following tracheostoma complications can be delicate, as well as redo resections of recurrent stenoses. All appropriate techniques of mobilization of the trachea to reduce tension on the suture line have to be managed as well as double-lumen tube ventilation, handling of sterile tube ventilation across the operating field, and high-frequency jet ventilation. Experience and detailed planning of surgical strategy is of utmost importance in marginal cases. There is always some degree of tension in all tracheal anastomoses, but this does not preclude healing of the suture line. Recurrent stenosis is best avoided by choosing an appropriate length of the resected segment, both in strictures and in tumors.