We describe a technique used in a patient for resection of adenoid cystic carcinoma arising from the left main bronchus and extending along the lateral wall of the lower trachea without carinal invasion. A flap was mobilized from the noninvolved lateral wall of the left main bronchus, which was left attached to the carina. This was used to close the defect in the lower trachea with the implantation of the left main bronchus, avoiding a tracheal sleeve pneumonectomy. Clinical course of this case was good. The pedicled autologous bronchial flap provides reliable material to repair and reconstruct a massive central airway defect.
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