Tracheal resection--state of the art

Area of Science:

• Thoracic surgery
• Surgical oncology

Background:

• Tracheal stenosis is a significant complication of long-term artificial respiration and can also result from tumors.
• Sleeve resection and end-to-end anastomosis are considered primary surgical options for tracheal stenosis.

Purpose of the Study:

• To analyze the outcomes of tracheal sleeve resection and end-to-end anastomosis in patients with tracheal stenosis.
• To evaluate the efficacy and safety of this surgical technique across different thoracic units.

Main Methods:

• Retrospective analysis of 73 patients who underwent tracheal resection and reconstruction.
• Data collected from two different thoracic surgery units, noting variations in surgical approaches and laryngeal mobilization techniques.

Main Results:

• Postintubation stenosis was the primary indication in 63% of cases.
• The 30-day postoperative mortality rate was 8%, with an overall mortality of 19%.
• Satisfactory functional results were achieved in 73% of patients, including those with malignant tumors. Restenosis occurred in 6 patients.

Conclusions:

• Tracheal sleeve resection with end-to-end anastomosis is a viable and effective treatment for tracheal stenosis.
• The use of resorbable materials, irrespective of surgical technique, appears to prevent restenosis.
• Careful patient selection, diagnostic procedures, and surgical technique are crucial for optimal outcomes.