Cicatricial tracheal stenosis. Is prevention possible? A single-region experience

Motus I.Ya.; Konstantinova O.S.; Giss N.A.

doi:https://doi.org/10.17116/hirurgia202306142

Motus I.Ya.

Ural Research Institute for Phthisiopulmonology

ORCID: 0000-0002-3092-6504

Konstantinova O.S.

Ekaterinburg City Central Clinical Hospital No. 23

ORCID: 0000-0002-2012-0144

Giss N.A.

Ekaterinburg City Central Clinical Hospital No. 23

ORCID: 0000-0003-4765-1831

Cicatricial tracheal stenosis. Is prevention possible? A single-region experience

Authors:

Motus I.Ya., Konstantinova O.S., Giss N.A.

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Journal: Pirogov Russian Journal of Surgery. 2023;(6): 42‑47

DOI: 10.17116/hirurgia202306142

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To cite this article:

Motus IYa, Konstantinova OS, Giss NA. Cicatricial tracheal stenosis. Is prevention possible? A single-region experience. Pirogov Russian Journal of Surgery. 2023;(6):42‑47. (In Russ.)
https://doi.org/10.17116/hirurgia202306142

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

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OBJECTIVE

To develop the measures for prevention and treatment of tracheal stenosis in various phases of disease.

MATERIAL AND METHODS

We analyzed 290 patients who underwent long-term mechanical ventilation between 2006 and 2021. The main causes of previous intensive care with prolonged ventilation were combined trauma and stroke. All patients were divided into two groups. Group I included 149 people who underwent decannulation in a specialized department with further staged endoscopic follow-up. Group II included 141 patients with cicatricial tracheal stenosis and no follow-up. All patients underwent endoscopic treatment, tracheal resection and staged reconstructive plastic surgery.

RESULTS

In the 1^st group, tracheal stenosis occurred in 28 cases (18.8%). Of these, initial (edematous and granulation) stenoses were detected in 17 (60.7%), granulation-fibrous stenoses — in 11 (39.3%) cases. Endoscopic treatment was successful in 24 (85.7%) patients. Four patients with tracheomalacia underwent circular tracheal resections. In the 2^nd group, all patients required surgical interventions (circular resections — 71 cases, staged reconstructive plastic surgery — 70 patients). Among 70 patients after reconstructive surgery, 24 (34.2%) ones recovered, and 28 (40%) patients need for cannula. Seventeen (24.2%) patients are unavailable for follow-up, and 1 patient (1.42%) died from concomitant disease. Complications after circular resection occurred in 16 cases (24.6%), postoperative mortality was 2.7%.

CONCLUSION

Follow-up after prolonged mechanical ventilation and tracheotomy makes it possible to prevent severe forms of tracheal stenosis and carry out early endoscopic treatment.

Keywords:

tracheostomy

tracheal stenosis

prophylaxis

surgical treatment

Authors:

Motus I.Ya.

Ural Research Institute for Phthisiopulmonology

ORCID: 0000-0002-3092-6504

Konstantinova O.S.

Ekaterinburg City Central Clinical Hospital No. 23

ORCID: 0000-0002-2012-0144

Giss N.A.

Ekaterinburg City Central Clinical Hospital No. 23

ORCID: 0000-0003-4765-1831

Received:

18.10.2022

Accepted:

11.11.2022

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