Repair of a defect in the cervical trachea with thyroid-pericardium flap: A case report

RATIONALE: Primary end-to-end anastomosis is common in adult trachea resection. Nevertheless, considering that the utilization of grafts is still essential for restoring defect in long-segment tracheal resection surgery, long-segment tracheal resection and reconstruction still remain challenging. Herein we present a novel case in which we resected a large tracheal mass and reconstructed the long-segment defect through using a thyroid-pericardium flap, which has not been reported yet. PATIENT CONCERNS: A 35-year old male patient was admitted due to ‘Repeated dry cough for 2 years, shortness of breath after activities for 1 month’. Patient had no other obvious symptoms. DIAGNOSES: CT revealed that a large neoplasm was located in the cervical trachea and the pedicle was in the tracheal membrane, with total length of approximately 6 cm. Positron emission tomography computed tomography demonstrated an abnormally elevated levels of glucose metabolism in the upper part of the posterior tracheal wall. Therefore, this lesion was primarily considered as a malignancy. INTERVENTIONS: The patient was performed by a primary resection of long-segment tracheal mass followed by thyroid-pericardium composite tissue flap for reconstruction. OUTCOME: The operation was successful, without hydrops or pneumatosis in the mediastinum. One week postoperatively, CT showed that there was no pneumomediastinum and mediastinal abscess. Three weeks postoperatively, fiber bronchoscope showed the flap with normal color and the unobstructed tracheal cavity. The patient healed without complication. LESSONS: The thyroid-pericardium flap is a convenient, secure, and effective material for long-segment trachea mass resection and reconstruction.