[Resection of the trachea in acquired cicatricial stenosis]

The objective of the submitted paper is to draw attention to the possible occurrence of post-cannulation ciccatrial stenoses of the trachea after long-term artificial pulmonary ventilation and possibilities of a surgical solution. The optimal therapeutic method is resection of the stenotic portion of the trachea. The authors present an account on 22 patients where during the period from 1996-1998 a resection of the trachea was performed. Of basic importance for indication for resection of the trachea is bronchoscopic, X-ray (tomograms) and CT examination which assesses the diameter, site and length of the stenosis. The limiting factor is assessment of the length of the stenotic portion. In stenoses longer than 5-6 cm it is useful to consider insertion of a stent. The authors made resections of the trachea of a maximum length of 55 mm. As to postoperative complications restenoses were most frequent and were resolved by implantation of a Montgomery T-tube. Indications of patients for surgery on account of stenosis of the trachea calls for close interdisciplinary collaboration of the bronchologist, radiologist and thoracic surgeon. Due to the small number of patients operated with this complication it is useful to concentrate these patients in specialized departments.