In line with data reported in the literature, the authors consider that the careful protection of the tracheal suture with abundant vital tissue is of fundamental importance in the prevention of complications in tracheal resective-reconstructive surgery. This procedure in fact reduces the risk of necrosis and subsequent fistulization of tracheal tissue and prevents decubitus of the suture on the innominate arterial wall, avoiding possible ulceration with fistulization and tracheal hemorrhage.