Carinal resection and reconstruction.

Successful outcomes for carinal resection and reconstruction depend upon many factors. Careful patient selection for patients who can tolerate the physiologic effects of the operation cannot be underestimated. Understanding the safe limits of resection, the technical details of airway reconstruction, and ongoing improvements in intraoperative and postoperative care should minimize the morbidity and mortality rates previously reported with this procedure. In addition, further work from institutions with considerable experience in carinal resection is needed to better define the long-term outcome for patients with bronchogenic carcinoma in close proximity to or involving the carina. Prior studies have suggested reasonable survival rates can be expected in the absence of involved mediastinal nodes or distant metastatic disease.