Surgical Outcomes of Post Intubation Tracheal Stenosis (Endotracheal Tube and/or Tracheostomy Tube)

Abstract

Background: Tracheal intubation for long time can lead to tracheal stenosis at different levels
from the tip of endotracheal tube up to the subglottic and glottis area. The most common sites are
the cuff of endotracheal tube and the stoma after tracheostomy. We have variable choices for the
treatment including laser, endoscopic dilatation, tracheal stents, and tracheal resection.
Patients and Methods: this is aprospective study of 40 patients who had tracheal stenosis after
prolonged intubation. We admitted them to the thoracic surgery unit in Kasr Alainy Hospital,
Cairo University from the period between October 2018 and October 2019 and were managed by
bronchoscopic dilatation initially followed by primary tracheal resection and re-anastomosis.
Results: Tracheal resection and re-anastomosis was successful in 38 patients (95%) with
excellent results and no post-operative symptoms. Regarding complications in the study only two
patients developed recurrent tracheal stenosis following primary resection and re-anastomosis
who needed permanent tracheostomy .One mortality case due to cardiac cause.
Conclusion: Tracheal resection and re-anastomosis is an excellent definitive management
regarding complete symptomatic resolution, total hospital stay and interventional complication.
Regarding the timing of application, success in early stages of disease onset without the need for
prolonged conservative management is more superior to its delayed application to avoid disease
progression