Complex Post-intubation Tracheal Stenosis in Covid-19 Patients

Area of Science:

• Surgery
• Pulmonology
• Critical Care Medicine

Background:

• Tracheal complications, specifically post-intubation tracheal stenosis (PITS), are a significant concern in patients requiring prolonged endotracheal intubation for coronavirus disease-2019 (COVID-19).
• Effective management strategies for complex PITS in the context of COVID-19 are crucial for patient recovery and long-term respiratory health.

Purpose of the Study:

• To evaluate the safety and efficacy of tracheal resection and reconstruction in patients with COVID-19-related complex PITS.
• To compare outcomes of tracheal reconstruction in COVID-19 patients versus non-COVID-19 patients with PITS.

Main Methods:

• A retrospective analysis of 15 patients who underwent tracheal resection and reconstruction for complex PITS between March 2020 and April 2021.
• Patients were divided into two groups: seven with COVID-19 and eight without.
• Data collected included presenting symptoms, stenosis characteristics, surgical details, postoperative complications, and follow-up duration.

Main Results:

• No statistically significant differences were observed between the COVID-19 and non-COVID-19 PITS groups regarding symptoms, stenosis severity, resected segment length, or postoperative complications.
• The COVID-19 group had a significantly longer duration of endotracheal intubation (21.0 days) compared to the non-COVID-19 group (12.0 days).
• Tracheal resection and reconstruction demonstrated favorable results in both groups.

Conclusions:

• Tracheal resection and reconstruction can be performed safely and successfully in COVID-19 patients with complex PITS.
• Key factors for favorable outcomes include comprehensive preoperative assessment, appropriate surgical technique selection, and diligent postoperative follow-up.