Tracheobronchial Resection and Reconstruction

Abstract

Tracheobronchial pathology is uncommon and consists of benign tracheal or bronchial stenosis, primary malignant neoplasms of the airway, lung cancer with central airway involvement, and metastatic tumors to the airway or mediastinum resulting in extrinsic or intrinsic airway pathology. These problems can produce significant morbidity and are also often immediately life threatening if they produce critical airway narrowing. Successful management of airway lesions may correct or palliate impending suffocation, dyspnea, and obstructive pneumonia. Techniques for airway construction may prevent the need for a lifelong tracheostomy and allow preservation of laryngeal function in benign strictures as well as provide treatment with curative intent for airway tumors. Patients with lung cancer or low-grade bronchial tumors may be resected using bronchoplastic techniques in situations that would not otherwise be amenable to standard surgical resection. These patients may also benefit from the pulmonary preservation that bronchoplastic procedures allow. Successful outcomes depend largely on careful patient selection and careful attention to the meticulous details of airway reconstruction.

Key Words:

Trachea - bronchial - stenosis - tumor - resection - bronchoscopy