Tracheal replacement with heavy Marlex mesh. Circumferential replacement of the cervical trachea.

Abstract

Adequate surgical excision of tumors involving the trachea may require the replacement of entire segments of the trachea. Deformities of the trachea secondary to injuries and infections occasionally require segmental tracheal grafts. Animal experimentation and several clinical trials have done much to advance our knowledge of the problems involved in reconstruction and replacement of the trachea, and recently these studies have been extensively reviewed.4,7Almost invariably, infection, migration of the graft, ingrowth of fibrous tissue, and stenosis have plagued such efforts, and until now, no entirely satisfactory graft has been available for the replacement of circumferential defects in the trachea. An ideal tracheal graft must possess several characteristics. It must be of sufficient rigidity to maintain an open airway and prevent collapse from fibrous contraction. It must be stable in tissue fluids and acceptable to the host, even in the presence of infection. And, finally, such a tracheal graft