Combined esophagectomy and carinal pneumonectomy

The trachea and esophagus share a common blood supply from a longitudinal artery along the tracheoesophageal groove on each side. Esophagectomy, especially with lymph node dissection, compromises the blood supply to the trachea and carina resulting in ischemia at the anastomosis and predisposing to failure. As a result, combined esophagectomy with circumferential tracheal or carinal resection and reconstruction has been reported only sporadically (1-4).