Reconstruction of the trachea and stem bronchi with Neville prosthesis.

Abstract:  Fifty-four patients with tracheal stenosis due to benign stricture and malignancy underwent airway reconstruction with a molded Silicone prosthesis (Neville Prosthesis). In 40 patients, the trachea was reconstructed with a straight prosthesis; of these 29 had a postintubation stricture and 11 a malignancy. In the former group, there was one early death from erosion of the innominate artery and five late deaths from a variety of causes. The postoperative complications were related to granulomas at the anastomotic site in four patients and were due to the use of non-absorbable suture material. Subglottic granulomas occurred in two patients and were successfully treated with fulguration. The lesion was resected and the trachea reconstructed with the prosthesis in eight individuals, five of whom are alive, one to six years postoperatively. Of the three patients, in whom the prosthesis served as an intraluminal stent, one who received irradiation is alive three years after operation. In 14 patients, in whom a carinal resection was performed for malignancy, five individuals are alive, from one to eleven years after surgery. There were four suture line granulomas in the entire group. All of the deaths were attributable to residual or disseminated cancer.