Outcome of surgical treatment for proximal long segment post intubation tracheal stenosis

Abstract

BackgroundPost intubation long segment tracheal stenosis is a serious problem which usually requires multiple methods of treatment. The aim of this study was to evaluate the results of surgical treatment in long segment post intubation tracheal stenosis.MethodsBetween 2004 to 2008, 20 patients with proximal long segment tracheal stenosis and resection of over 40% of tracheal length, were analyzed in terms of age, sex, clinical symptoms, etiology of stenosis, length of stenosis and resection, role of suprahyoeid release with bilateral hyoeid bone cutting maneuver, post operative complications and life quality 3 year after surgery.ResultsM/F was 2/5, with the average age of 23.5 ± 0.5 years. Average length of stenosis was 4.2 ± 0.4 cm and the average length of resected segment was 5.2 ± 0.4 cm. Early postoperative complications occurred in 4 patients (20%), 5 patients (25%) had late stenosis and 4 of them were treated with multiple dilation and one patient needed tracheostomy and prolonged T. tube. We didn’t have any mortality. 80% of patients had excellent surgical results in follow up period.ConclusionSurgery is the best method of treatment in long and multi segment tracheal stenosis.

Does duration of mechanical ventilation affect the resection length in benign tracheal stenosis?

“…[8,24] Additionally, inappropriate suturing technique may accelerate the granulation tissue formation after tracheal resection. [25] In our study, wound infection occurred in two patients, while restenosis or suture dehiscence did not develop. We believe that the causes for this low complication rate are use of absorbable suture materials, the suture technique we performed, and our avoidance of excessive tracheal dissection.…”

Total Unilateral Obstruction by Sputum Immediately after Tracheal Bougienage

“…To avoid these complications, preoperative interventions such as repeated bougienage, tracheal laser cauterization, stent insertion, and mitomycin C spray are performed. [6,7] Bougienage is performed under direct view of the stenotic lesion with bronchoscopy and may result in edema due to damage from the direct contact of bronchoscopy.…”

Chirurgie der Trachea

“…Plattenepithelkarzinome und adenoid-zystische Karzinome stellen ca. 2 2 ⁄3 3 der primären Tracheamalignome dar, gefolgt von Adenokarzinomen, Mukoepidermoid-und anderen mesenchymalen Karzinomen. Gutartige primäre Tracheatumoren sind Chondrome, Fibrome, fibröse Histiozytome, Keimzelltumoren, Papillome und Hämangiome.…”