Surgical technique for partial-layer tracheal resection for esophageal cancer with tracheal invasion

Combined resection for tracheal invasion in esophageal cancer is extremely challenging. Tracheal resection with cervical or mediastinal tracheostomy is often performed; however, this procedure has high morbidity rates and results in loss of voice. We present our experience performing a partial-layer tracheal resection, "tracheal shaving," for esophageal cancer with tracheal invasion. We successfully performed tracheal adventitia and tracheal muscle resection in a patient with adventitial invasion, and the shaving area was reinforced by omental covering along with a gastric tube reconstructed through the posterior mediastinum. We believe that our "tracheal shaving" technique may potentially allow curative resection in selected T4 cases while preserving laryngeal function. It may serve as a minimally invasive alternative to conventional tracheal resection, although further evaluation is required.