Tracheal resection--state of the art.

Sleeve resection of the trachea and reconstruction by end-to-end anastomosis is seen as the method of choice in the treatment of short and long stenoses of the trachea following long-term artificial respiration and tumors. The experience with tracheal resection in 73 patients operated upon at 2 different thoracic units is analyzed. Postintubation was the main indication for operation in 63% of the patient population. The 30-day postoperative mortality rate was 8% with a total mortality of 19%. A satisfactory functional result was attained in 73% of the patients operated upon including those with malignant tumors. Restenoses occurred in 6 of the 73 patients who underwent surgery. Different approaches to tracheal resection were chosen in the 2 clinics and the possibility of mobilizing the larynx was used in a different way. A preference for resorbable material was noted regardless of the operative technique and has prevented restenosis. The diagnostic procedures considered mandatory, the indications for surgery and the various operative techniques are discussed.