Tracheal reconstruction after lower tracheal resection using the inverted right bronchus--an experimental study.

An experimental study of tracheal reconstruction after lower tracheal resection using the inverted bronchus was performed in 8 dogs. After right upper lobectomy, the five cartilage rings of the lower trachea, ending three cartilage rings above the carina, was circumferentially resected; the right bronchus was transected just above the right second carina, the portion of the transected trachea above the carina was closed, and the right bronchus was inverted. The peripheral end of the upper trachea was anastomosed to the inverted right bronchus, and the intermediate bronchus was anastomosed to the lateral wall of the left bronchus. After completion of the airway reconstruction, the anastomotic site was wrapped with an omental flap. Although anastomotic complication were observed in two dogs, all the dogs survived the operation. Bronchoscopically and histopathologically, the findings for the inverted bronchus were almost normal three to four weeks after the operation. The clinical relevance of such a tracheal reconstruction is discussed.