Reconstruction of the trachea after resection for neoplasm

Sixty-three patients with primary tracheal tumours were seen in a 15-year period. The most common lesion was squamous-cell carcinoma, the next most common lesion was adenoid cystic carcinoma, and the remaining lesions were a variety of malignant and benign lesions. There were 3 carcinoid tumors in the group. Twenty-four cylindrical resections of the trachea, 2 lateral resections of the trachea, and 10 carinal reconstructions were performed. The balance of the patients seen in this period of time were not amenable to single-stage reconstruction and were managed by staged procedures, by irradiation, or by no treatment at all. Twenty-eight of the patients in the group with resections had primary tumors and 8 had secondary tumors. Secondary tumors included carcinoma of the thyroid, carcinoma of the esophagus, and recurrent carcinoid tumor in the left main bronchus. Although the numbers in any group are small and the period of follow-up not very long, indications are that surgical removal of squamous-cell carcinoma and adenoid cystic carcinoma of the trachea, usually with adjunctive irradiation, provides good palliation or the possibility of cure. Resection of benign primary tumors and low-grade malignant tumors resulted in excellent palliation and usually cure. Resection of selected secondary tumors did not offer much prospect for cure but did provide long-term palliation.