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Short tracheal resection with a termino-terminal anastomosis is typically a safely performed procedure. However, replacement of segments longer than 50% of the tracheal length in adults and 30% in children has become a great challenge in thoracic surgery. Different tracheal substitutes have been attempted, both experimentally and in clinical practices, to replace long tracheal segments. These include synthetic materials, non-tracheal grafts, tracheal allografts, tailored tube conduits and most recently, biomaterials (1).

Long tracheal replacement or the philosopher’s stone