对侧胸锁乳突肌肌蒂锁骨骨膜瓣修复气管壁缺损

目的 根据胸锁乳突肌肌蒂锁骨骨膜瓣的特点，修复颈部肿瘤术后的气管壁缺损。方法 同侧胸锁乳突肌血运因行淋巴清扫或放疗而受损害者，可应用对侧胸锁乳突肌肌蒂锁骨骨膜瓣，充分游离其蒂部，注意保护甲状腺下动脉，用骨膜瓣修复气管壁缺损。结果 本组以对侧骨膜瓣修复气管壁后皆可见上皮化及骨化形成，皆正常拔除气管插管，未见气管狭窄。结论 对侧胸锁乳突肌肌蒂锁骨骨膜瓣可修复患侧胸锁乳突肌血运受损害的气管壁缺损，扩大了肌骨膜瓣的应用范围。     

肌瓣肌骨瓣修复颜面凹陷畸形

应用胸锁乳突肌肌瓣及胸锁乳突肌锁骨复合瓣。修复4例腮腺混合瘤、腮腺浅叶切除后耳下凹     

带耳大神经的胸锁乳突肌肌瓣在腮腺癌手术修复中的应用

目的探讨腮腺深叶癌根治手术切除后,面部凹陷畸形及面神经缺损进行功能性修复的新方法,并评价临床疗效。方法对12例腮腺深叶癌侵袭周围骨质的患者,采取开放面神经管,将癌瘤、腮腺、受累面神经及周围骨质(包括乳突、茎乳孔、茎突及下颌升支后缘)扩大切除,利用面神经管内段正常的神经干断端与胸锁乳突肌肌瓣相连的耳大神经进行吻合,同时利用胸锁乳突肌肌瓣填充凹陷畸形。结果开放面神经管利用耳大神经胸锁乳突肌肌瓣功能性修复的方法,9例腮腺区凹陷畸形明显恢复常态,2例因肿瘤复发再次手术切除留有明显凹陷畸形,1例因局部感染,组织液化,肌肉萎缩,出现凹陷。面神经功能完全恢复,恢复时间最短为12周,最长20周,平均163周。同时提高了肿瘤的局部控制率。结论开放面神经管腮腺癌根治术,用耳大神经-胸锁乳突肌肌瓣即时修复,既达到了面部凹陷畸形的整复,又实现了面神经的功能性修复,同时减少肿瘤的局部复发,符合功能外科修复的发展要求,是一种临床应用效果比较理想的方法。     

锁骨下小切口经胸锁乳突肌颈前肌间隙腔镜辅助甲状腺部分切除术15例报告

目的探讨锁骨下小切口经胸锁乳突肌颈前肌间隙入路腔镜辅助甲状腺部分切除的方法和效果。方法15例单侧甲状腺良性结节，锁骨下小切口2-3cm，经胸锁乳突肌颈前肌间隙入路，腔镜辅助下行甲状腺部分切除。结果15例均获成功，手术时间40—80min，平均50min。术中出血10～50ml，平均20ml，无并发症。术后3-4d出院。15例随访1～12个月，平均7个月，无复发。结论经锁骨下小切口胸锁乳突肌颈前肌间隙入路腔镜辅助甲状腺部分切除手术损伤小，出血少，并发症发生率低，安全，术后恢复快。     

经胸锁乳突肌前缘径路行甲状腺切除术的体会

目的探讨经胸锁乳突肌前缘径路行甲状腺切除的手术方法。方法回顾分析3年间本院采用经胸锁乳突肌前缘径路不横断颈前肌群行甲状腺肿瘤切除术治疗2 3例(A组)患者的临床资料,并与同期施行传统手术方法治疗的甲状腺肿瘤2 5例(B组)的情况进行比较。结果 A组手术时间、失血量和住院时间均低于B组,两组之间差异有统计学意义(P0.0 5)。A组切口及周围皮肤平整,术后疼痛轻,颈部切口周围皮肤感觉无明显异常。结论经胸锁乳突肌前缘径路行甲状腺切除术治疗甲状腺肿瘤是安全可行的,此术式创伤小、操作简易,疗效可靠。     

岛状额瓣加胸锁乳突肌皮瓣一期修复颊癌术后大面积洞穿性缺损一例

目的探讨颊部大面积洞穿性缺损的修复方法和胸锁乳突肌皮瓣、额瓣联合修复的优缺点。方法2003年7月行颊癌扩大切除,功能性颈淋巴清扫术患者1例,遗留组织缺损范围皮面9 cm×7 cm,黏膜面4.5 cm×3.0 cm。以甲状腺上血管、枕动脉和颈外静脉胸锁乳突肌肌支为血管蒂的胸锁乳突肌皮瓣修复颊黏膜面,以颞浅血管为血管蒂的岛状额瓣修复颊部皮面,皮瓣大小分别为5 cm×3 cm和10 cm×6 cm。结果患者术后皮瓣、皮片均全部成活,创面Ⅰ期愈合。2周痊愈出院,颊部皮色、质地好。随访1年,肿瘤无复发,生活自理,语言、饮食正常。结论胸锁乳突肌皮瓣和额部岛状瓣可作为颊癌术后颊部大面积洞穿性缺损的一期修复的方法,操作简便、易行,且经济。     

侵犯气管的局部晚期甲状腺癌的外科诊疗经验

背景与目的 手术是治疗侵犯气管的局部晚期甲状腺癌的首选方法。根据侵犯气管位置和程度的不同,其处理方法也不尽相同。选择合适的治疗方式对患者的预后和生活质量尤为重要。通常甲状腺癌气管侵犯时已伴有颈淋巴结转移、颈部大血管粘连,甚至食管和喉的侵犯,因其解剖结构复杂多变,目前仍没有高级别的循证医学证据指导治疗。本文旨在探讨侵犯气管的局部晚期甲状腺癌的临床特点和外科处理方法。方法 回顾2019年7月—2021年7月重庆大学附属肿瘤医院头颈肿瘤中心诊治的20例侵犯气管的局部晚期甲状腺癌患者资料,其中,男16例,女4例;年龄13~78岁,中位年龄53.5岁;甲状腺滤泡癌2例,髓样癌2例,甲状腺乳头状癌16例;3例锐性削除受侵气管外壁,5例行局部气管窗式切除术,10例行气管袖式切除+端端吻合术,1例行全喉切除+气管永久造瘘,1例行全喉切除+永久气管造瘘+胸大肌皮瓣修复,术后均接受131I治疗或分子靶向药物的综合治疗。结果 患者随访时间4个月至2年不等。3例锐性削除受侵气管外壁患者未见肿瘤复发,无气管瘘;5例行气管窗式切除患者均Ⅰ期缝合气管创面;10例气管袖式切除+端端吻合患者均未出现气道狭窄和双侧声带麻痹,其中1例出现术后局部感染和局部气管瘘口,换药后愈合;1例同时侵犯喉行全喉切除+气管永久造瘘,1例同时侵犯喉和颈部皮肤行全喉切除+永久气管造瘘+胸大肌皮瓣修复,后2例患者带管生存。截止投稿时本文纳入患者未出现肿瘤进展情况。结论 颈段气管的切除和修复是外科医生常常需要面对和处理的难题,笔者的治疗原则是在病灶可完整切除和患者能耐受的前提下,尽可能选择外科手术治疗。对于侵犯气管及其邻近器官的局部晚期甲状腺癌患者,应在MDT讨论指导下制定治疗方案,术前进行充分的方案准备和应对并发症的措施。根据侵犯程度不同选择合适的气管切除范围和修复重建方式,首选Ⅰ期修复和重建的方案,其次选择Ⅱ期或多期方案。但无论选择手术治疗还是综合治疗,治疗宗旨都是延长甲状腺癌患者生存期和提高生活质量。     

会厌在外伤性喉气管狭窄整复中的应用

目的探讨会厌在外伤性喉气管狭窄整复中的应用及术后疗效。方法1988年1月～2002年2月，收治外伤性喉气管狭窄42例，其中喉狭窄33例，喉气管狭窄9例。年龄9～48岁，平均28．2岁。病程1～26个月，平均10．2个月。均采用手术治疗，方法：①会厌下移 胸骨舌骨肌肌筋膜瓣整复术；②会厌下移 胸骨舌骨肌肌筋膜瓣 胸锁乳突肌锁骨膜瓣整复术。结果术后37例10～75d拔除气管套管，拔管率为88．1％，5例戴管，占22．9％；42例均于术后9～24d拔除胃管，其中5例轻度误吸，经练习后1周内均恢复正常进食；25例放置扩张子，拔除时间为9～19d；42例中5例术后2～5个月有肉芽组织生长，经支撑喉镜下激光治疗1～3次治愈；术后均获1年～3年4个月随访，37例拔管者喉功能完全恢复，5例戴管者部分恢复喉功能。结论会厌用于整复喉气管狭窄，具有取材简便、抗感染能力强、成活率高及结构稳定等优点，与双肌蒂胸骨舌骨肌肌筋膜瓣联合应用能修复较大范围的缺损。胸锁乳突肌锁骨膜瓣其骨膜面光滑而致密，不易发生萎缩，是修复气管壁缺损的理想材料。     

胸锁乳突肌肌皮瓣修复颌面部缺损

应用胸锁乳突肌肌皮瓣修复口腔颌面部恶性肿瘤切除后软组织缺损16例,男7例,女9例。修复颊部6例、舌部7例、牙龈与口底3例,术后均获良好效果。修复前应检查手术治疗病例无远处转移,局部无瘤残存。预测肿瘤切除后所致缺损面积的大小,在同侧胸锁乳突肌的中下段设计单或双叶岛状肌皮瓣。单叶肌皮瓣一般设计在胸锁乳突肌的下1/3段,位于胸骨头与锁骨头之间,呈长棱或横梭形。双叶瓣之一位于胸锁乳突     

无充气腋窝入路腔镜下甲状腺手术中经胸大肌肌间隙寻找胸锁乳突肌的应用价值

目的探索胸大肌形态学特征及毗邻结构的解剖关系, 研究通过胸大肌肌间隙寻找胸锁乳突肌的路径。方法选取2020年12月至2022年9月在安徽理工大学第一附属医院和中国科学技术大学附属第一医院行甲状腺手术156例甲状腺乳头状癌患者, 常规行无充气腋窝入路腔镜下甲状腺手术为A组, 在此基础上通过胸大肌肌间隙寻找胸锁乳突肌为B组, 每组各78例。结果 B组78例中寻找到典型胸大肌肌间隙共71例(91%), 未能寻找到的7例(9%)。胸大肌锁骨部与胸肋部间隙的形态学分为3型:分隔明显型(Ⅰ型)、分隔不明显-部分重叠型(Ⅱa型)、分隔不明显-完全吻合型(Ⅱb型)。B组平均手术时间为(105±15)min, 少于A组的(156±27)min, 差异有统计学意义(t=14.523, P<0.01);B组术后1 d引流量为(49±6)ml, 少于A组的(51±6)ml, 差异有统计学意义(t=2.273, P=0.024)。两组患者的术中出血量、术后住院时间及并发症发生率相比差异均无统计学意义(t=0.557, P=0.578;t=0.134, P=0.894;χ2=1.844, P=0.174)。...     

Adenoid cystic carcinoma of the trachea. Experience with 16 patients managed by tracheal resection

Sixteen patients with adenoid cystic carcinoma of the trachea were treated by resection, on occasion combined with radiotherapy. In 14 patients in whom circumferential resection was done, the defect was reconstructed by primary anastomosis (5 patients, up to 8.5 cm. resected), prosthetic replacement (6 patients, up to 11 cm. resected), or laryngectomy with end tracheostomy (3 patients). In 3 remaining patients a partial tracheal resection was closed with a patch of autologous tissue.There were no operative deaths in 11 patients (12 resections) managed by primary anastomosis, autologous graft, or end tracheostomy; and 8 of these 11 patients are alive and clinically free of local tumor 2 to 18 years following resection. Prosthetic replacement in 6 patients resulted in 4 postoperative deaths (3 due to innominate artery erosion); good palliation was obtained in the 2 survivors. In 6 patients receiving preoperative radiotherapy, no local recurrence of tumor has been observed, and tracheal healing was not impaired.Extensive sleeve resection of the trachea with primary anastomosis is now possible and is the treatment of choice for this tumor. Preoperative radiotherapy may delay or obviate local recurrence.     

Tracheal growth after resection and anastomosis in puppies

Tracheal morphology, morphometric changes, and growth and histologic changes were studied in puppies submitted to tracheal resection and anastomosis. Fifteen mongrel puppies about 12 weeks old and weighing on an average 5.5 kg were operated under general anesthesia using fluothane. A median cervicotomy incision was made in ten puppies (experimental group, EG) and the proximal 14 tracheal rings were resected (average length 5.08 cm or about 35% to 38% of total tracheal length). One layer anastomosis was done using vicryl 4.0 maintaining the average tension of 1,450 g. Five puppies (control group, CG) were submitted to tracheal transection and anastomosis and the following parameters were studied. Tracheal morphology the trachea of the EG was a rounded triangle whereas in the CG it was oval in shape, there was increase in the intercartilageneous spaces in the EG, no granulation tissue was present, two mucous webs were seen in the EG and one in the CG. Morphometric changes average tracheal length EG 13 cm, CG 17.7 cm, intercartilagenous space EG 3.08 mm, CG 1.3 mm, intercricothyroid space EG 1.2 cm, CG 0.53 cm, sagittal and transverse tracheal thickness at the anastomosis EG 2.6 and 3.3 mm, CG 2 and 1.5 mm, sagittal and transverse diameter reduced on an average 2 mm in EG. Histology Moderate fibrosis was found at the level of anastomosis with no modification of chondrocytes at the cartilagenous rings in the EG. Even with high anastomotic tension, the dogs had normal tracheal growth without stenosis; the sagittal and transverse growth at the anastomosis in the EG was 90% and 85%, respectively, when compared with the CG.     

原发性气管癌44例临床分析

比较原发性气管癌手术与非手术治疗的疗效，探讨影响本病预后的因素。回顾性分析经组织学证实的４４例原发性气管癌病人的临床与随访资料。手术切除１８例；非手术治疗２６例（放疗采用钴６０或高能Ｘ线，靶区剂量为６０～７０Ｇｙ；化疗采用ＣＯＭＦ或ＡＭＦＰ方案４～６个疗程）。结果采用ＫａｐｌａｎＭｅｉｅｒ法计算其１、３、５年生存率，手术切除者分别为８３．３％、６６．７％和３３．３％，非手术治疗者分别为７３．１％、４２．３％和１５．４％。ｌｏｇｒａｎｋ检验显示无统计学意义，Ｐ＞０．０５。气管上段腺样囊性癌预后相对较好，治疗后５年内约有７７．３％病人死于肿瘤末控、复发或转移。结论：原发性气管癌手术与非手术者的预后似乎无明显差异，影响本病预后的因素主要为其发病部位和病理类型     

Resection of thyroid carcinoma infiltrating the trachea.

We have treated surgically 11 patients with thyroid carcinoma that had infiltrated into the trachea. Three patients had primary tumours, and eight had recurrent tumours after previous operations. Sleeve resection of trachea was performed where thyroid carcinoma had proliferated; the trachea was reconstructed by end-to-end anastomosis. In two patients 10 rings of the trachea were resected. In three patients the anterior half of the cricoid cartilage was resected along with the cervical trachea. In one patient tracheoplasty was performed using partial extracorporeal circulation because severe tracheal stenosis prevented endotracheal intubation. Two of the 11 patients died from the surgery and one from disseminated metastases. One patient who had undergone tracheal resection for thyroid carcinoma three years and five months previously had a recurrence of the tumour in the trachea adjacent to the anastomosis, and a second tracheal resection was performed. In three patients postoperative laryngeal stenosis occurred. Five patients are alive and well two years and one month to four years and seven months after their operations. The histological pattern of the tumour was papillary adenocarcinoma in all 11 patients.     

Surgical management of acquired non-malignant tracheo-esophageal fistulas

BACKGROUND: The aim of this study was to evaluate the results of one-stage surgical management of acquired non-malignant tracheo-esophageal fistulas (TEF). METHODS: Six consecutive patients, 2 men and 4 women with median age of 65 (range 34-71) years had tracheo-esophageal fistulas resulting from a median of 33 (range 20-86) days of intubation via oro-tracheal or tracheostomy tubes. Median TEF length was 2.6 (range 1.8-3.5) cm and the defect was associated with a tracheal stenosis near or immediately below the stoma in 4 cases (66%). Tracheal resection and anastomosis with primary esophageal closure was carried out in 4 patients; direct closure of the tracheal and esophageal defects with muscle flap interposition was performed in 2 patients: tracheal stoma was left in site because of the high risk of postoperative respiratory insufficiency related to chronic obstructive pulmonary disease. RESULTS: All six patients had complete control of the TEF. One perioperative death occurred on day 27 (16%) related to the recurrence of endocranial bleeding. The 5 long-term survivors were routinely submitted to tracheo-bronchoscopic control and only one (20%) revealed granulation tissue at the suture line requiring two consecutive bronchoscopic removals. CONCLUSIONS: Postintubation tracheoesophageal fistula is usually best treated with one-stage surgical procedure: which preferably consists of tracheal resection and anastomosis and primary esophageal closure.     

Tracheal window resection and reconstruction via sternocleidomastoid flap for invasive thyroid carcinoma

 Open in a separate windowOBJECTIVESThe aim of this study was to present surgical techniques and evaluate outcomes of a sternocleidomastoid muscle (SCM) myoperiosteal flap used for the reconstruction of tracheal or laryngotracheal defects after the radical resection of invasive thyroid carcinoma.METHODSA retrospective study was performed for patients at Peking Union Medical College Hospital from January 2008 to December 2018 of papillary thyroid carcinoma with tracheal or laryngotracheal invasion. Patients were enrolled only when they received window resection and reconstruction via an SCM myoperiosteal flap. The primary outcome was a stable airway, and the secondary outcome was survival.RESULTSA total of 15 invasive thyroid carcinoma patients were enrolled in this study. Laryngotracheal and tracheal reconstruction were performed in 11 and 4 patients respectively, with a median vertical defect of 3.5 cm (3.0, 4.5). A stable airway was achieved in 14 patients postoperatively. One patient experienced tracheal stenosis and received a second operation of tracheal sleeve resection and end-to-end anastomosis 105 days after the first operation. Tracheostomy was conducted in 5 out of 15 patients in whom the vertical defects were larger than 4 cm, and the tubes were extubated after a median time of 56 days (32, 84). The median observation time was 55 months (48, 86), and all 15 patients achieved a stable airway and showed no evidence of local recurrence at the end of follow-up.CONCLUSIONSFor thyroid carcinoma with tracheal or laryngotracheal invasions, window resection with the SCM myoperiosteal flap reconstruction presented positive results in terms of a stable airway as well as oncological outcomes. The SCM myoperiosteal flap can be an appropriate reconstruction strategy, especially when the defects reach the thyroid cartilage.     

颈部肌肉联合瓣包裹自体气管游离移植的实验研究

目的 研究肌肉瓣在再植气管重建血运中的作用。方法 实验用犬32只,采用单侧胸头肌瓣和双侧胸骨舌骨肌－胸骨甲状肌联合瓣包裹不同长度的气管段,以及不同肌肉瓣包裹5个环的气管段,分别行自体气管游离移植。术后通过纤维支气管镜检查、粘膜血流量的测定、病理学检查、血管造影以及存活率和通畅度的计算,研究各组犬的存活情况。结果 有肌肉瓣包裹组中,短于4cm的再植气管术后第1周时粘膜充血水肿,易出血;激光多普勒血流仪测到粘膜下有血流存在,粘膜血流量达到正常的60％,其在近吻合口和中间部位无明显差别;造影显示有密集的血管从肌肉瓣长入再植气管;病理检查其结构完整,管腔内为假复层柱状纤毛上皮所覆盖,软骨无变性坏死;再植气管均能长期存活。但长于4cm的再植气管术后第1周时9只犬有6只的中间段粘膜呈苍白或灰黑色,近吻合口处粘膜充血水肿,易出血;中间部位的粘膜血流量明显低于近吻合口处;7只犬再植气管的中间段管塌陷或肉芽组织增生。无肌肉瓣包裹组再植气管的粘膜在术后第1周时即呈黑色,5只犬有4只无法检测到粘膜血流,实验只犬随后因再植气管坏死而死亡。结论 单侧胸头肌瓣和双侧胸骨舌骨肌－胸骨甲状肌联合瓣包裹可以维持短于4cm再植气管的长期存活。     

Complications of tracheal sleeve pneumonectomy: personal experience and overview of the literature

OBJECTIVES: Tracheal sleeve pneumonectomy, although technically demanding, is considered the choice for tracheobronchial angle cancers. Complications in our 49 tracheal sleeve pneumonectomies are reviewed. Results, complications, and technical aspects are critically discussed. Although series in the literature differ in selection of patients and surgical techniques and extend over long periods, we attempt to compare our experience with results from the literature. METHODS: From 1983 to September 1999, 60 patients eligible for tracheal sleeve pneumonectomy after conventional staging underwent operation. A Sybilla Fome-Cuf ventilation tube (Bivona, Inc, Gary, Ind) was used starting in 1987 to facilitate anastomosis. Since 1993, all patients have undergone video-assisted thoracoscopy immediately before the operation. RESULTS: There were 11 (18.3%) exploratory thoracotomies, 48 right tracheal sleeve pneumonectomies, and 1 left tracheal sleeve pneumonectomy. Among the tracheal sleeve pneumonectomies, we recorded 4 (8.2%) perioperative deaths (myocardial infarction, n = 1; heart failure, n = 1; pulmonary edema, n = 1; gastric ulcer hemorrhage, n = 1; and anastomotic fistula in a patient who received high-dose radiation before the operation, n = 1). We observed 5 (10.2%) complications (lung edema, n = 1; transitory recurrent nerve palsy, n = 2; empyema without fistula cured conservatively, n = 1; and pneumonia, n = 1). Anastomotic stenosis did not occur. Twenty-six (53%) patients are alive 14 to 87 months postoperatively, 12 (24.5%) of these more than 5 years postoperatively. Five (10.2%) died of mediastinal recurrence at 6 and 54 months. Two others (4.1%) died in road accidents. CONCLUSIONS: Tracheal sleeve pneumonectomy is a demanding operation with a high risk of complications. Analysis of literature and personal experience shows that complications can be greatly reduced through accurate selection of patients, precise technique, and optimal postoperative care. Long-term survival equals that obtained after standard pneumonectomy.     

Multiple tracheal resections and anastomoses in a blue and gold macaw (Ara ararauna)

A 1.5-year-old, male blue and gold macaw (Ara ararauna) was anesthetized for a health examination and blood collection. The following day it was returned for episodes of coughing. The bird was presented again 13 days after the initial presentation with severe dyspnea. A tracheal stenosis was diagnosed by endoscopy and treated by surgical resection of 5 tracheal rings and tracheal anastomosis. The bird was discharged but returned 2 days later with a recurrent stenosis. Bougienage and balloon dilation of the stenotic area were performed separately; each resulted in less than 48 hours' improvement in clinical signs after treatment. A second tracheal resection and anastomosis was performed, during which an additional 10 tracheal rings were removed. This second anastomosis was significantly more difficult to complete given the marked variation in diameter of the proximal and distal tracheal segments. The macaw recovered without complication and has had no recurrence of respiratory abnormalities 2 years after the second surgery. This report describes the longest total tracheal segment to be resected, followed by tracheal anastomosis, in a psittacine bird. The positive outcome in this case suggests that, when surgical therapy is elected, an aggressive approach is necessary to prevent recurrence of tracheal stenosis. In addition, macaws can recover well even after significant lengths of the trachea are resected.     

Primary tracheal tumors: experience with 14 resected patients.

OBJECTIVE: Primary tracheal tumors are rare. Management includes interventional endoscopy, surgery and radiotherapy. METHODS: Between 1987 and 1996, 14 patients treated by resection and reconstruction of the trachea and bifurcation for primary tracheal tumors were retrospectively analyzed. RESULTS: The most common histological finding was adenoid cystic carcinoma (n=7), followed by a squamous cell carcinoma (n=2), a mucoepidermoid carcinoma (n=2), a carcinoid tumor (n=1) and two benign tumors (xanthogranuloma, pleomorphic adenoma). Various reconstruction techniques were used and one prosthesis was implanted. Eight of the patients required preoperative Nd-YAG laser recanalisation. Six were treated by postoperative external beam radiotherapy, in three cases combined with endoluminal brachytherapy. Two major postoperative wound-healing impairment at the anastomosis occurred. Four minor wound-healing disorders were successfully treated by interventional endoscopy. Two patients died postoperatively with mediastinitis respectively with bilateral pneumonia. A local recurrence was observed in only two cases. At the last follow-up in January 1998, nine patients were still alive. We observed five long-term survivors (>6 years) with an adenoid cystic carcinoma or mucoepidermoid carcinoma. CONCLUSIONS: Extensive segmental resection of the trachea is the treatment of choice for primary malignant and occasionally for benign tracheal tumors. Interventional endoscopy is a part of modern tracheal surgery.