Tracheal resection and reconstruction.

Tracheal resection and reconstruction may be required in patients with tracheal obstruction due to foreign bodies, trauma, parasitic granulomas, or tracheal tumors. Primary end-to-end anastomosis is the best means of reconstruction after the diseased tissue is resected. If anastomosis can be accomplished without excessive tension, few complications occur. However, if there is tension at the anastomotic site, the incision may separate, causing scar tissue to form and stenosis to occur. Many techniques may be used to prevent anastomotic stenosis, including tracheal mobilization, tension-relieving sutures, and head-neck immobilization. Grafts or prosthesis may be required when primary end-to-end anastomosis is impossible. More frequent complications are associated with the use of grafts and prostheses than with end-to-end anastomosis. These most commonly include stenosis, prosthesis migration, and erosion of adjacent blood vessels.