Results and prognosis of tracheal segmental resection

We evaluated 12 patients who underwent tracheal segmental resection. Nine had malignant neoplasm (thyroid carcinoma, 7 ; tracheal adenoid cystic carcinoma, 1 ; esophageal carcinoma, 1) and 3 benign stenoses (traumatic stenosis, 2 ; postradiotherapic stenosis, 1). Seven underwent laryngotracheal anastomosis, and 5 tracheotracheal anastomosis. The number of resected tracheal rings was 3 to 12 (5.8 ± 2.6). Anastomotic leakage occurred in 2 patients in whom more than 7 tracheal rings were removed. One of them previously received high dose radiotherapy (60 Gy), and the other concurrently underwent bilateral neck and mediastinal lymph node dissection as well as combined resection of internal jugular and innominate veins. The average period until the patients could swallow without dysphagia was 24.5 ± 19.3 days after operation. The 3-year and 5-year survival rates of the patients with thyroid carcinoma who underwent tracheal segmental resection were 85.7 % and 57.1 %, respectively. These results suggested that extensive regional lymph node dissection and combined resection of adjacent organs as well as the number of resected tracheal rings and previous radiation might be the risk factors of anastomotic leakage. Tracheal segmental resection should be performed as curative resection for the patients with thyroid carcinoma invading the airway.