Problems of tracheal or carinal resection combined with subtotal esophagectomy

In the case of tracheobronchoplasty combined with esophageal resection, healing of the tracheobronchial anastomosis may be compromised by interference with the blood supply to the anastomosis, as the tracheal lateral vessels are removed with the esophagus and the posterior membranous portion of the trachea is no longer supported by the esophagus. Covering of the anastomosis by the muscle flap is one of the methods for these disadvantages, but preservation of bronchial arteries and feeding vessels to the trachea is better. Indication for these procedures should be determined by precise judgement of the extent of malignancy.