Comparison of the difference between post-intubation tracheal stenosis and post-tracheostomy tracheal stenosis: a...

With the rapid development of critical care medicine, tracheal intubation and tracheotomy are increasingly used. Meanwhile, the number of tracheal stenosis cases, as one of the complications, is gradually rising. Bronchoscopic interventional treatment is quite effective for tracheal stenosis. However, the differences in treatment effects between post-intubation tracheal stenosis (PITS) and post-tracheostomy tracheal stenosis (PTTS) remain unclear. Also, there is a lack of in-depth and systematic exploration on the distinctions between these two types of tracheal stenosis with different causes. Thus, this article will describe and compare PITS and PTTS in detail, explore their differences and differences in treatment effects, aiming to provide a basis and guidance with certain reference value for clinical medical practice.

In this cross-sectional observational study, the data of PITS and PTTS patients undergoing bronchoscopic interventional therapy in the Department of Respiratory and Critical Care Medicine II, and Oncology Department of Emergency General Hospital and the Department of Respiratory Medicine in Dongzhimen Hospital of Beijing University of Chinese Medicine were retrospectively analyzed.

The PTTS group had a higher prevalence of neurological diseases and burns, with more common dynamic stenosis; the PITS group was more commonly associated with drug poisoning respiratory, digestive, and circulatory system diseases, with scar tissue being more prevalent (P<0.05). Stenosis length was significantly longer in the PTTS than in the PITS. In terms of treatment modalities balloon dilatation and scleroscopic laser were more frequently used in the PITS group than in the PTTS group (P<0.05). After treatment, both groups showed significant reductions in the degree of stenosis and modified Medical Research Council (mMRC) scores, with a significant increase in Karnofsky Performance Status (KPS) scores (P<0.05), and a significant improvement in the degree of endoscopic stenosis (P<0.05). The PTTS group had fewer average hospitalizations and longer intervals between the two hospitalizations (P<0.05).

The clinical characteristics of the two patient groups are different. Bronchoscopic intervention showed significant efficacy on PITS and PTTS, with a more pronounced improvement in KPS scores in PTTS patients.