Resection of primary carinal squamous cell carcinoma and reconstruction of the carina

Resection of the tracheal carina presents special problems of reconstruction. We recently treated a 46-year-old male with primary carinal squamous cell carcinoma removed successfully by wedge resection.Partial wedge resection of four cartilagenous rings of the lower trachea and the carina was performed, and a primary side-to-end anastomosis was made between the carina and the shortened right main bronchus.With plastic reconstruction, the suture line of the upper border of the tracheal defect assumed the shape of an inverted T. The postoperative course was uneventful. The patient was discharged 50 days after the operation.Bronchoscopic findings six months after operation showed no stenosis or granulation of the new carina which formed two bifurcations.