Surgical Treatment of Benign Tracheal Stenosis: Analysis of Twenty-One Patients

  • Aynur Bas
  • Ali Celik Gazi University, School of Medicine, Department of Thoracic Surgery
  • Yusuf Unal
  • Ismail Cuneyt Kurul
  • Abdullah İrfan Taştepe
Keywords: Trachea, benign stenosis, surgery,

Abstract

Objective: The objective of this study was to retrospectively evaluate 21 cases of tracheal stenosis that underwent surgery due to benign tracheal stenosis. Methods: A total of 21 patients who underwent surgery due to benign tracheal stenosis in our clinic between 2010 and 2017 were retrospectively evaluated. The patients were analyzed in terms of age, gender, surgical indication, surgical approach, comorbidities, length of the trachea resected, postoperative complications, the duration of hospitalization and development of restenosis. Results: Out of 21 patients, 12 were male and nine female. Surgical indication was postintubation tracheal stenosis in 15 patients. The mean age was 39.6 (10-83) and the mean length of resection was 3.33 cm. Collar incision was performed in 16, collar and sternotomy incision in 3, and sternotomy incision in 2 patients. Complication rates were high in patients with comorbidity. Conclusion: Tracheal surgery is mostly applied due to benign disease in addition to the malignant diseases of the tracheal surgery is mostly performed with low rates of morbidity and mortality, and the outcomes are usually satisfactory.

References

- Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospectivestudy of 150 critically ill adult patients. Am J Med 1981; 70: 65-76.

- H.C. Grillo, D.M. Donahue, D.J. Mathisen, J.C. Wain, C.D. Wright. Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg 1995;109:486-92.

- Puma F,Vannucci J, Santoprete S, Urbani M, Cagini L, Andolfi M, Potenza R, Daddi N. Surgery and perioperative management for post-intubation tracheoesophageal fistula: case series analysis. J ThoracDis 2017; 9: 278-86.

- Liu J,Wu W, Liu S, Xu Z, Wang J, Li B. A modified tracheal transaction approach for the repair of non-malignant tracheoesophageal fistulas: A report of 5 cases. ORL J Otorhinolaryngol Relat Spec. 2017; 79: 147-52.

- Miñambres E,Burón J, Ballesteros MA, Llorca J, Muñoz P, González-Castro A. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur J Cardiothorac Surg 2009; 35: 1056-62.

- Pearson FG. Idiopathic laryngotracheal stenosis. J Thorac Cardiovasc Surg 2004; 127: 10–1.

- Bhora FY, Ayub A, Forleiter CM, Huang CY, Alshehri K, Rehmani S, et al. treatment of benign tracheal stenosis using endoluminal spray cryotherapy. JAMA Otolaryngol Head Neck Surg 2016; 142: 1082-87.

- Moylan JA, Chan CK. Inhalation injury--an increasing problem. Ann Surg 1978; 188: 34-7.

- Zias N, Chroneou A, Tabba MK, Gonzalez AV, Gray AW, Lamb CR et al. Post tracheostomy and post intubation tracheal stenosis: Report of 31 cases and review of the literature. BMC Pulm Med 2008;8:18.

- Koshkareva Y, Gaughan JP, Soliman AM. Risk factors for adult laryngotracheal stenosis: a review of 74 cases. Ann Otol Rhinol Laryngol 2007; 116: 206-10.

- Brichet A, Verkindre C, Dupont J, Carlier ML, Darras J, Wurtz A, et al. Multidisciplinary approach to management of postintubation tracheal stenoses. EurRespir J 1999; 13: 888–93.

- Leschber G.Management of tracheal surgery complications. Thorac Surg Clin. 2014; 24: 107-16.

- Kim SS, Khalpey Z, Hsu C, Little AG. Changes in tracheostomy- and intubation-related tracheal stenosis: implications for surgery. Ann Thorac Surg 2017; 104: 96470.

- Wright CD, Grillo HC, Wain JC, Wong DR, Donahue DM, Gaissert HA, et al. Anastomotic complications after tracheal resection: Prognostic factors and management. J Thorac Cardiovasc Surg 2004; 128: 731–9.

- Lanuti M, Mathisen DJ. Management of complications of tracheal surgery. Chest Surg Clin N Am 2003; 13: 385-97.

- Bisson A, Bonnette P, el Kadi NB, Leroy M, Colchen A, Personne C, et al. Tracheal sleeve resection for iatrogenic stenoses (subglottic laryngeal and tracheal). J Thorac Cardiovasc Surg 1992; 104: 882-7.

- Petrou M, Goldstraw P. The management of tracheobronchial obstruction: a review of bronchoscopic techniques. Eur J Cardiothorac Surg 1994; 8: 436-41.

- Martinez-Ballarin JI, Diaz-Jimenez JP, Castro MJ, Moya JA. Silicone stents in the management of benign tracheobronchial stenoses. Tolerance and early results in 63 patients. Chest 1996; 109: 626-9.

- George M, Lang F, Pasche P, Monnier P. Surgical management of laryngotracheal stenosis in adults. Eur Arch Otorhinolaryngol 2005; 12: 609–15.

- Marques P,Leal L, Spratley J et al. Tracheal resection with primary anastomosis: 10 years experience. Am J Otolaryngol 2009; 21: 415-8.

- Grillo HC: The management of tracheal stenosis following asisted respiration. J Thoracic Cardiovasc Surg 1969; 57: 52.

- Ciccone AM, De Giacomo T, Venuta F, Ibrahim M, Diso D, Coloni GF, et al. Operative and non-operative treatment of benign subglottic laryngotracheal stenosis. Eur J Cardiothorac Surg 2004; 26:818–22.

- Hadi U, Hamdan AL. Diagnosis and management of tracheal stenosis. J MedLiban 2004; 52: 131-5.

- van den Boogert J, HansHoeve LJ, Struijs A, Hagenouw RR, Bogers AJ. Single-stage surgical repair of benign laryngotracheal stenosis in adults. HeadNeck 2004; 26: 111-7.

- Cosano Povedano A, Muñoz Cabrera L, Cosano Povedano FJ, Rubio Sánchez J,Pascual Martínez N, Escribano Dueñas A. Endoscopic treatment of central airway stenosis: five years' experience. Arch Bronconeumol 2005; 41: 322-7.

Published
2019-03-25
Section
Original Research