Temporary transection of the trachea in cervical esophagectomy.

A new method to preserve the larynx and to achieve a better exposure of the cervical esophagus was performed in four patients with cervical esophageal carcinoma. The trachea, which prevented exposure of the esophagus, was cut, keeping the continuity of the recurrent laryngeal nerves. The tracheo-esophageal space was opened like a double door. The cervical esophagus was replaced with a substitution followed by tracheal reconnection. Three different substitutions were used for the reconstruction of the cervical esophagus: free jejunum, free skin tube graft and stomach. This procedure offers a further excision of the esophagus while preserving the larynx, and results in free surgical margins and safe anastomoses of the alimentary tract. This method is applicable for a curative operation of carcinoma without invasion to the trachea to offer the patient a better quality of life.