title: Autologous tracheal replacement for cancer.
abstract: Surgical research has failed during fifty years to find an ideal substitute for the trachea after extended resection. All the prostheses could erode the adjacent structures or lead to infection or obstructive issues. Innovation in surgery development has been improved using novel techniques of plastic surgery. During the last ten years, we have developed a technique using free fasciocutaneous flaps. This allows us to construct tubes for tracheal replacement. The most accurate flap used for this technique is the forearm free flap (FFF). Reinforcement of the flap with autologous strips of cartilage harvested from the last ribs offers sufficient resistance to respiratory pressure. This technique is also completely autologous without any stent in the tracheal lumen. From 2004 to 2015 we have already reconstructed the trachea of 16 patients for 12 primary tracheal neoplasms [including 9 adenoid cystic carcinoma (ACC) and 3 squamous cell carcinoma (SCC)], 3 secondary tracheal Neoplasms and one for benign lesion. This article describes the indications, determination of resectability, patient selection, subheading for surgery, postoperative management and results of this technique.
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, 133, Avenue de la résistance, 92350 Le Plessis Robinson, France. d.fabre@ccml.fr.
authors.forename: Dominique
authors.initials: D
authors.lastname: Fabre
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Fadel
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Sacha
authors.initials: S
authors.lastname: Mussot
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Kolb
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Leymarie
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Olaf
authors.initials: O
authors.lastname: Mercier
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Chevalier
authors.affiliation: Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Thoracic Oncology Institute, Paris Sud University, Le Plessis Robinson, France.
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Dartevelle
mesh_terms: D000328:Adult; D000368:Aged; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012272:Ribs / Q000637:transplantation*; D012307:Risk Factors; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014134:Tracheal Neoplasms / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adenoid cystic carcinoma (ACC); autologous replacemen; forearm free flap (FFF); squamous cell carcinoma (SCC); trachea