[Tracheolaryngeal resection for cicatricle stenosis].

Area of Science:

• Thoracic Surgery
• Laryngology
• Surgical Oncology

Background:

• Cicatricle stenosis of the tracheolaryngeal segment presents a significant surgical challenge.
• Treatment approaches have evolved over decades, necessitating analysis of long-term outcomes.

Purpose of the Study:

• To determine the safest and most effective surgical treatment for cicatricle stenosis of the tracheolaryngeal segment.
• To analyze different surgical approaches and their outcomes in a large patient cohort.

Main Methods:

• Retrospective analysis of 1128 patients treated between 1963 and 2015.
• Comparison of surgical techniques and outcomes between two distinct treatment periods (1963-2000 and 2001-2015).
• Focus on tracheal resection with anastomosis and tracheolaryngeal resection.

Main Results:

• Overall morbidity after tracheal resection with anastomosis was 5.6% in the later period, with higher rates (17%) after tracheolaryngeal anastomosis.
• No lethal outcomes were reported after 94 tracheolaryngeal resections.
• Good long-term results (89.8%) were achieved with circular resection, leading to a quality of life similar to healthy individuals.
• Preserving cicatricle tracheal segments with T-shaped airway tubes negatively impacted long-term quality of life.

Conclusions:

• Tracheal resection followed by anastomosis is an effective treatment for cicatricle tracheal stenosis.
• Modern surgical techniques have improved safety and efficacy, leading to better long-term quality of life.
• Avoiding preservation of stenotic segments is crucial for optimal patient outcomes.