Vladimir Parshin¹, Andrew Volkov¹, Evgeny Trofimov², Dmitry Bazarov¹.

¹Thoracic division, National research centre of surgery, Moscow, Russia; ²Microsurgery division, National research centre of surgery, Moscow, Russia.

Background: Now there is a set of publications devoted to surgical treatment of cicatrical stenoses of a trachea, however liquidation of extensive window defects of the trachea arising after excising of its wall, remains a difficult problem and to this day. AIMS. To develop a technique allowing to liquidate window tracheal defects of almost any sizes by single-step procedure.

Materials and Methods: 51 patients with extensive tracheal defects were managed using microsurgical technologies for elimination defect. From them, in 35 cases it was used dermo-osteal radial flap with revasculization, in 16 cases a dermo-cartilaginous autograft and in 1 dermal flap. The flap plasty was finishing of stages of reconstructively-plastic interventions. In total at 51 patients before its carrying out 118 operations on formation of a lumen of a trachea have been executed. Operation was made simultaneously by team of thoracic and microsurgeons. The equipment of a time endoprosthesis carried out under endoscopic control. An endoprosthesis deleted after performance of operations on different terms.

Results: All 51 patients were discharged. The maximum term of observation makes 12 years. In one case there was no disturbance of a circulation of a graft and, as consequence of a good revascularization of tissues, its pyesis.

Conclusions: Elimination of extensive defects of a trachea with using of microsurgical complexes of autogenous tissues with revasculization is new intervention technology in reconstructive surgery of a trachea, allowing to liquidate large window defect by one-step procedure.