Results of extended resection of tumors involving the cervical part of the trachea.

Extended resection of the trachea with construction of a mediastinal tracheostomy was performed upon 21 patients with primary or recurrent carcinoma involving the cervical part of the trachea. In 12 patients, major complications developed, and eight died of these complications. Necrosis of skin flaps and tracheal wall, leading to sepsis of the mediastinum and rupture of major vessels, were the two most common complications and causes of death. Three patients remained free of disease for 143, 77 and 48 months. A review of this experience suggests that this procedure should be limited to patients witha tumor localized to the cervical portion of the trachea and that well vascularized skin flaps--myocutaneous flaps--should be used to resurface the mediastinum and base of the neck as a means of preventing most of the complications reported in this investigation.