Carinal reconstruction of the montage type for adenoid cystic carcinoma of carina

We report a case of a tracheal tumor on the carina treated by tracheobronchoplasty after radiotherapy. A 48-year-old man was admitted for severe dyspnea due to carinal stenosis. Adenoid cystic carcinoma on the carina was revealed. The tumor extended from the lower 3rd tracheal ring to both main bronchi. Airway stenosis was treated by local injection of ethanol and cautery with Nd-YAG laser. A silicon stent was placed in the stenotic site and preoperative irradiation was performed (35 Gy). After tumor regression, carinal reconstruction of the montage type (CRm) was performed. End to side anastomosis was performed with a telescopic running suture. The postoperative course was uneventful. The residual tumor of the trachea was well controlled with postoperative irradiation (35 Gy) and local injection of cisplatin, and the patient was discharged. CRm demonstrates more complications at the anastomotic site than other types of tracheobronchoplasty. Based on our findings, common complications included dehiscence and stenosis of the end to side anastomotic site. Telescopic running suture was considered as a reliable procedure for this site.