• Qinzi Xu, Yu Deng, Shengling Fu, Yangkai Li, Wei Sun, Ni Zhang, and Xiangning Fu.
• Department of Thoracic Surgery, TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China.
• Ann. Thorac. Surg. 2012 Apr 1; 93 (4): 1070-4.

BackgroundWe developed a novel technique for tracheobronchial reconstruction after resection of carcinoma of the right upper lung involving the right main bronchus and lower trachea. Preliminary results of the technique are reported.MethodsBetween December 2007 and October 2011, 9 patients underwent treatment with our new technique. The right upper lobe was resected together with the involved right main bronchus and right lateral wall of the lower trachea. Closure of the trachea was started at the level of the carina and continued upward, leaving an oval opening at the upper end of the tracheal defect, to which the bronchus intermedius was reimplanted. The sutured lower trachea became the extension of the left main bronchus.ResultsThe procedure was completed successfully in all 9 patients. Two patients underwent partial carinal resection, 2 underwent replacement of the superior vena cava by interposition graft, 2 underwent partial resection of the superior vena cava, and 1 underwent partial resection of the esophageal wall. There were no perioperative deaths. No major complications, including dehiscence, stenosis, and adult respiratory distress syndrome, were observed. Arrhythmia occurred in 2 patients, and vocal cord paresis and pneumonia occurred in 1 patient. One patient died 31 months after operation, and 1 patient was lost to follow-up 28 months after operation, without tumor recurrence. The other 7 are alive to date.ConclusionsDespite this being a small series and short follow-up, this tracheobronchial reconstruction shows encouraging preliminary results with low mortality and morbidity, and could be an alternative to other methods for the treatment of carefully selected patients with advanced carcinoma of the right upper lobe.Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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