A Novel Technique of Tracheal Reconstruction with Autologous Bronchial Pedicle Flap

Abstract

We describe a technique used in 2 patients for resection of a bronchogenic carcinoma arising from the right main bronchus and extending along the lateral wall of the lower trachea without carinal invasion. A right pneumonectomy was performed in the first case, and lower and middle lobes were preserved in the second case after extended upper lobe resection. A flap was mobilized from the non-involved left lateral wall of the right main bronchus, which was left attached to the carina. This was used to close the defect in the lower trachea. An autologous bronchial pedicle flap provides reliable material to repair and reconstruct a massive central airway defect.

Key words

thoracic surgery - heart and lung transplantation - cardiovascular surgery

References

• 1 Meyer A, Krueger T, Lepori D et al. Closure of large intrathoracic airway defects using extrathoracic muscle flaps.  Ann Thorac Surg. 2004;  77 397-405
• 2 Fica M, Rodríguez P, Prats R et al. Tracheal hamartoma: pericardial flap replacement of membranous tracheal wall.  Eur J Cardiothorac Surg. 2002;  21 (2) 355-357
• 3 Janssen L M, Van Osch G J, Li J P et al. Tracheal reconstruction: mucosal survival on porous titanium.  Arch Otolaryngol Head Neck Surg. 2009;  135 (5) 472-478
• 4 Gaissert H A. Primary tracheal tumors.  Chest Surg Clin N Am. 2003;  13 247-256
• 5 Roviaro G, Varoli F, Romanelli A et al. Complications of tracheal sleeve pneumonectomy: personal experience and overview of the literature.  J Thorac Cardiovasc Surg. 2001;  121 234-240