SURGICAL-MANAGEMENT OF TRACHEAL TUMORS

Background. Resection of tracheal tumors is particularly challenging w hen the neoplasm involves the carina or is located in close proximity. We reviewed our experience with 22 tracheal resections for tumor. Met hods. In this retrospective review, adenoid cystic carcinoma was diagn osed in 13 patients, squamous cell carcinoma in 5, typical carcinoid i n 2, and leiomyoma and benign fibrous histiocytoma, in 1 each. There w ere 19 segmental resections with direct anastomosis, and 3 complex res ections in which the carina was involved. Results. One patient with tu mor in the trachea and left main bronchus underwent resection through simultaneous bilateral thoracotomy and died. During 2 to 17 years of f ollow-up, 2 patients died of unrelated disease, 2 died of metastases, and 1 is receiving radiotherapy for recurrence. Sixteen patients are w ell and free of tumor. Conclusions. Complete resection of all neoplast ic tissue is mandatory, but benign and low-grade malignant tumors shou ld be resected conservatively with preservation of lung parenchyma. Op tions for treatment of neoplasms involving trachea and left bronchus s hould include resection of the neoplasm in two stages, thus minimizing trauma of each operation.