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Ann Thorac Surg 2003;75:610-619
© 2003 The Society of Thoracic Surgeons

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Review

Development of tracheal surgery: a historical review. Part 1: techniques of tracheal surgery

^a Division of General Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
^b Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA

* Address reprint requests to Dr Grillo, Massachusetts General Hospital, Blake 1570, 55 Fruit St, Boston, MA 02114, USA
e-mail: pguerriero@partners.org

The first 300 words of the full text of this article appear below.

	Introduction

 
Despite the antiquity of tracheostomy, tracheal surgery was the last anatomic subdivision of cardiothoracic surgery to develop. In 1950, Belsey [1] observed that "The intrathoracic portion of the trachea is the last unpaired organ in the body to fall to the surgeon, and the successful solution of the problem of its reconstruction may mark the end of the ‘expansionist’ epoch in the development of surgery." After the introduction of intratracheal anesthesia [2, 3], enormous strides were made in pulmonary surgery in the 1930s, in esophageal surgery in the 1940s, and, after cardiopulmonary bypass became a reality, in cardiac surgery in the 1950s. In 1961, Richard Meade noted in A History of Thoracic Surgery [4]: "Carcinoma of the trachea is a rather rare lesion and when it is found it is usually found to be entirely inoperable. In rare instances the lesion is so localized that the involved trachea can be resected, and with mobilization the ends can be brought together. This is seldom true and one is faced with the problem of what to do after resection of the trachea." The 1960s proved to be a decade when advance in tracheal surgery quickened [5].

By 1990, resection rates for tracheal tumors reached 63% for squamous carcinoma, 75% for adenoid cystic carcinoma, and 90% for other tumors [6]. The developments that led to such advances in 30 years between 1960 and 1990 deserve to be related in more detail than the page and a half devoted to airway surgery in another recent History of Thoracic Surgery [7].

The following, not a comprehensive review of the literature on tracheal surgery, is a selective account of tracheal surgical development. Emphasis is on beginnings and early development of important concepts and procedures. Current references are not necessarily . . . [Full Text of this Article]

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