Tracheal Resection and Reanastomosis: Cervical Approach

Tracheal stenosis can occur after controlled respiration with cuffed endotracheal or tracheostomy tubes. Such stenoses respond best to excision and reanastomosis. In more than half the cases presented, the posterior "party wall" was preserved, since pressure of the cuff was exerted against a yielding area, in contrast to the rigid anterior wall, where pressure leads to necrosis. Primary anastomosis with preservation of the posterior wall was, therefore, feasible in 50% of the cases, and circumferential excision was indicated only when the entire circumference of the trachea was involved. The surgical techniques for both of these contingencies are detailed, and our experience with 22 patients is described.