Two‐Stage Tracheal Repair for Well‐Differentiated Thyroid Carcinoma With Tracheal Invasion

Objective To evaluate a two‐stage tracheal reconstruction strategy for repairing extensive tracheal defects in well‐differentiated thyroid carcinoma (WDTC) with tracheal invasion. Methods Seventy‐four patients underwent tumor resection and tracheal excision, followed by staged reconstruction using a free posterior tibial flap ( n = 28), pedicled thoracoacromial flap ( n = 36), or pedicled supraclavicular flap ( n = 10). Functional recovery, decannulation, complications, and survival were analyzed. Results Demographic characteristics were comparable across groups. Tracheal defects were significantly larger in the free posterior tibial artery perforator flap group (9.14 ± 1.57 rings) versus the pedicled thoracoacromial (5.89 ± 2.59 rings) and supraclavicular (6.30 ± 1.49 rings) flap groups. The overall endotracheal tube removal rate was 95.9%, with no intergroup differences ( p = 0.533). Functional recovery (swallowing, speech, and respiration) was comparable among groups. The 3‐year survival rate was 78.4%, with no significant differences across groups ( p = 0.633). Conclusions Two‐stage tracheal reconstruction is a safe and effective approach for long‐segment tracheal defects in WDTC patients, offering satisfactory functional recovery. Further studies with larger cohorts and longer follow‐up are warranted to confirm long‐term efficacy. Level of Evidence 4.