Tracheal resection and anastomosis for malignancy: surgical and functional outcome

Primary malignant neoplasms of trachea and tracheal invasion by thyroid malignancies although rare are serious causes of morbidity and mortality. Management of tracheal tumours in general includes interventional endoscopy, surgery and radiotherapy. This paper describes the surgical and functional results of tracheal resections done in the surgical oncology department of a tertiary care cancer centre. Methods: This is a retrospective analysis of all patients with malignant tracheal tumours who underwent resection and anastomosis in the period 2005-2009. Nine consecutive patients with tracheal involvement either from locally invasive thyroid malignancy or from primary tracheal adenoid cystic carcinoma were included in the study. Results: Six patients had locally invasive differentiated thyroid cancer and three had adenoid cystic carcinoma. The male to female ratio was 2:1. All thyroid cases were papillary carcinoma with involvement of tracheal lumen. These patients underwent thyroidectomy along with tracheal resection- sleeve resection in four patients and window resection in two patients. Among the adenoid cystic carcinoma cases two patients were subjected to sleeve resection and one to window resection. Anastomosis was done after suprahyoid release and digital peri tracheal dissection. There were no major post op complications and all patients had normal voice after surgery. Eight out of nine patients are on regular follow up and are disease free till date. Conclusion: Tracheal resection is the treatment of choice for trachealtumours and is a safe procedure with good functional outcome.