Postintubation multisegmental tracheal stenosis: treatment and results

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Otolaryngology

Background:

• Postintubation tracheal stenosis can affect multiple, distinct airway segments.
• Managing these complex strictures often yields unpredictable results and is rarely documented.

Purpose of the Study:

• To evaluate the efficacy of different therapeutic strategies for patients with multisegmental tracheal stenosis.
• To analyze outcomes based on surgical approach for complex airway strictures.

Main Methods:

• A retrospective review of 648 patients treated for tracheal or subglottic stenosis.
• Analysis of 26 cases with two separate stenotic segments, comparing four treatment types: one-stage resection, two-stage resection, combined resection/non-resection, and non-resection only.
• Treatment selection was based on stenosis characteristics, location, and surgeon's judgment.

Main Results:

• The study included 26 patients (mean age 23.9 years; 76.9% male) with multisegmental stenosis.
• Sixteen patients achieved satisfactory results (good voice and airway); 7 required ongoing treatment, and 3 died (2 from T-tube obstruction, 1 from acute stenosis).
• Two complications were reported: 1 stomal fistula and 1 wound infection, with a mean follow-up of 21.5 months.

Conclusions:

• Surgical resection and reconstruction are viable for some patients with multisegmental tracheal stenosis, yielding good outcomes.
• For cases where complete resection is not feasible, combining surgical and non-surgical methods effectively manages most patients.