[Tracheobronchial segmental resection and reconstruction applied to surgical treatment of esophageal cancer with airway involvement]

Objective: To evaluate the efficacy of tracheobronchial segmental resection and reconstruction applied to surgical treatment in the patients with esophageal cancer with airway invasion. Methods: From January 2004 to April 2014, 13 patients in our center underwent radical esophagectomy combined with tracheobronchial segmental resection and reconstruction. Patient characteristics, operative procedures, postoperative complications and long-term survival were retrospectively reviewed. Results: All patients received complete resection (R0) with an average length of resected airway 2.77±0.73 cm. In addition, carinal resection plus lobar resection (including carinal pneumonectomy) was accomplished in 2 patients; 1 patient underwent aortic replacement. Complications were noted in 5 patients (39%) and 2 patients (15.38%) died within 30 days after operation. 4 patients (30.76%) suffered from airway anastomosis stenosis and all 3 of them died within 2 years after operation due to refusing bronchoscopy interventions. The overall 1-, 2-, and 5-year survival rates were 72.7%, 45.5%, and 24.2%, respectively, with a median survival time of 2 years (0.5-10 years). Conclusion: Tracheobronchial segmental resection and reconstruction can provide an opportunity of complete resection and a survival benefit for patients with esophageal cancer invading airway with acceptable morbidity and mortality. Postoperative airway anastomosis stenosis needs active treatment.