Tracheal resection after prolonged stenting in surgery for cicatricial stenosis

Parshin V.D.

University's Clinical Hospital №1, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Rusakov M.A.

Rossiĭskiĭ nauchnyĭ tsentr khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

Parshin V.V.

University's Clinical Hospital №1, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Amangeldiev D.M.

Sechenov First Moscow State Medical University, Moscow, Russia, Burdenko Clinic of Faculty Surgery, Moscow, Russia

Parshin A.V.

Sechenov First Moscow State Medical University, Moscow, Russia, Burdenko Clinic of Faculty Surgery, Moscow, Russia

Maer R.Yu.

Moscow city health department, Moscow, Russia

Tracheal resection after prolonged stenting in surgery for cicatricial stenosis

Authors:

Parshin V.D., Rusakov M.A., Parshin V.V., Amangeldiev D.M., Parshin A.V., Maer R.Yu.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(11): 5‑12

DOI: 10.17116/hirurgia20191115

Downloaded: 47

To cite this article:

Parshin VD, Rusakov MA, Parshin VV, Amangeldiev DM, Parshin AV, Maer RYu. Tracheal resection after prolonged stenting in surgery for cicatricial stenosis. Pirogov Russian Journal of Surgery. 2019;(11):5‑12. (In Russ., In Engl.)
https://doi.org/10.17116/hirurgia20191115

Подписка 2025 (Pirogov Russian Journal of Surgery)

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Objective — to analyze early and delayed results of various variants of circular tracheal resection (CTR) with anastomosis, to determine the safest approach, dates and conditions of correction, features of postoperative period in patients after previous tracheal surgery. Material and methods. There were 831 patients with cicatricial tracheal stenosis. CTR was made in 330 (39.7%) patients. Most patients had previous prolonged ICU-stay. The patients were divided into 4 groups. Group 1 consisted of 61 (18.5%) patients after previous prolonged tracheal stenting. Group 2 included 45 (13.6%) patients who underwent circular tracheal resection with a functioning tracheostomy. Tracheostomy tube served as a stent in these patients. Group 3 enrolled 32 (9.7%) patients with previous staged reconstructive plastic surgeries on cranial segment of the respiratory tract. Tracheostomy or stent were absent in 192 (58.2%) patients who underwent circular tracheal resection at the first hospitalization. These patients were enrolled into the fourth (control) group. Favorable outcomes (without complications and mortality) were achieved in 85.5% (n=282) of patients. Postoperative complications occurred in 48 (14.5%) patients. Mortality rate was 0.6% (n=2). The greatest number of complications including anastomositis and restenosis was noted in patients after CTR and previous tracheoplasty with T-tube (n=8, 25%). The most common complication in patients after tracheal resection and previous stenting was anastomositis (14.7%). Long-term results depended on postoperative complications and methods of their correction. Recurrent stenosis occurred in 5 (1.5%) patients within the period of 3 months — 8 years. CTR after previous tracheoplasty with T-tube was carried out in 4 of these patients. Conclusion. Tracheal resection after preliminary stenting or tracheostomy is quite safe and technically feasible. Stenting allows postponing radical surgery for correction of concomitant diseases and closure of tracheostomy as a focus of infection within the surgical approach and further tracheal anastomosis. Tracheal resection with simultaneous closure of tracheostomy results a higher rate of postoperative complications compared with preliminary stenting.

Keywords:

tracheal stenosis

tracheal resection

tracheal stenting

tracheoplasty

tracheostomy

tracheal stenosis

tracheal resection

tracheal stenting

tracheoplasty

tracheostomy

Authors:

Parshin V.D.

University's Clinical Hospital №1, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Rusakov M.A.

Rossiĭskiĭ nauchnyĭ tsentr khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

Parshin V.V.

University's Clinical Hospital №1, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

Amangeldiev D.M.

Sechenov First Moscow State Medical University, Moscow, Russia, Burdenko Clinic of Faculty Surgery, Moscow, Russia

Parshin A.V.

Sechenov First Moscow State Medical University, Moscow, Russia, Burdenko Clinic of Faculty Surgery, Moscow, Russia

Maer R.Yu.

Moscow city health department, Moscow, Russia

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