[Treatment of sclerotic stenosis of trachea]

An evident trend towards the increase of postintubational and posttracheostomic tracheal stenoses is observed in Georgia during the past 10-12 years. For example, during the period of 1998-2001 28 patients were admitted to our center with this diagnosis, while during 2001-2004 we treated 61 similar cases. According to several international publications overall frequency of postventilatory laryngotracheal stenoses is as high as 25%. At present time surgical intervention remains as a method of choice for treatment of tracheal stenoses including circular resection, step by step reconstructive plastic operations and different methods of tracheal recanalization. 89 patients 14-68 years of age were treated in our center during 1998-2004. 61 (68,5%) cases were presented with pathology within the cervical part of trachea and larynx. 28 (31,5%) cases were with intrathoracic tracheal stenosis. In 71 (79,8%) cases stenoses were induced by pulmonary ventilation by endotracheal tube and in 18 (20,2%) cases etiologic factor was posttracheostomic tracheal injury. Duration of intubations varied from 3 to 86 days. Mortality was 3 cases out of 89. In 2 cases mortality was due to anastomotic leakage, in 1 case--bleeding from brachiocephalic vessels. Based on our experience, an accurate follow up of diagnostic and treatment algorithms allows achievement of good results in 91% cases.