Prosthetic reconstruction of the trachea and carina.

Twenty-six patients with tracheal stenosis owing to benign stricture and malignancy have had airway reconstruction with a molded silicone rubber prosthesis. In 8 patients the distal trachea and carina were replaced with a bifurcated graft. One individual with respiratory insufficiency could not be weaned from the respirator and died in 3 weeks. Two other patients with malignancy died 15 and 18 months following operation from disseminated cancer. The remainder are living from 1 to 5 years postoperatively. Eighteen individuals have had the trachea reconstructed with a straight graft of silicone rubber. In 5 patients with long strictures the prosthesis was invaginated into the upper and lower ends of the trachea. Thirteen individuals had circumferential resection of the airway with end-to-end anastomosis of the graft to the trachea. There was one early death from erosion of the innominate artery and 5 late deaths unrelated to the prosthesis.