Surgical considerations in tracheal resection for tracheal stenosis

Five patients were succesfully operated upon for tracheal stricture following prolonged assisted ventilation with a cuffed tracheal tube. The operative exposures and techniques to be recommended with relation to site and extent of tracheal stenosis are discussed. Most tracheal resections can be carried out through a low cervical incision. Lesions of the lower part of the trachea (5 cm or less from the carina) are best approached through a right posterolateral thoracotomy incision. A stenosed tracheal segment of 4 cm or less can be resected easily by both routes without undue tension on the anastomotic line. The use of interrupted Prolene sutures is proposed for the tracheal anastomosis, because it produces much less tissue reaction than chromic catgut.