Key Points

• Diseases of the trachea that require surgical resection and reconstruction include idiopathic tracheal stenosis, postintubation injuries, and primary tumors of the trachea.
• Simple radiologic techniques without use of contrast medium will delineate most pathologic conditions of the trachea.
• Bronchoscopy is invaluable in determining the extent of airway disease preoperatively.
• Tracheal strictures need to be serially dilated with pediatric rigid bronchoscopes before endotracheal intubation.
• Dissection of the trachea remains close to its lateral border to avoid injury to the recurrent laryngeal nerves.
• The tracheal anastomosis is done with interrupted absorbable suture material (4-0 Vicryl).
• Anastomotic tension is minimized by neck flexion and traction sutures (2-0 Vicryl).
• A strap muscle flap is interposed between the tracheal anastomosis and the innominate artery.