Cicatricial tracheal stenosis in elderly and senile patients: immediate and long-term results of treatment

Topolnitskiy E.B.; Tsydenova A.N.

doi:https://doi.org/10.17116/hirurgia202308131

Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
National Research Tomsk State University

SPIN RSCI: 6744-9541
Scopus AuthorID: 35197267200
ResearcherID: T-5818-2018
ORCID: 0000-0002-5674-0177

Tsydenova A.N.

Siberian State Medical University;
Tomsk Regional Clinical Hospital

ORCID: 0000-0001-6670-9010

Cicatricial tracheal stenosis in elderly and senile patients: immediate and long-term results of treatment

Authors:

Topolnitskiy E.B., Tsydenova A.N.

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Journal: Pirogov Russian Journal of Surgery. 2023;(8): 31‑39

DOI: 10.17116/hirurgia202308131

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To cite this article:

Topolnitskiy EB, Tsydenova AN. Cicatricial tracheal stenosis in elderly and senile patients: immediate and long-term results of treatment. Pirogov Russian Journal of Surgery. 2023;(8):31‑39. (In Russ.)
https://doi.org/10.17116/hirurgia202308131

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

Использование инфографики авторами научных работ

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OBJECTIVE

To present treatment outcomes in elderly and senile patients with cicatricial tracheal stenosis (CTS) and features of their perioperative management.

MATERIAL AND METHODS

The study included 46 elderly and senile patients with CTS. We analyzed their gender and age, body mass index, etiology, extent and degree of stenosis, comorbidity index and ASA grade, postoperative complications according to TMM grading system.

RESULTS

Age of patients varied from 61 to 95 years (mean 66.38±8.65). Post-intubation stenosis was detected in 7 (15.2%) patients, post-tracheostomy CTS — in 39 (84.8%) patients (2 (4.3%) ones with tracheoesophageal fistula and 18 (39.1%) ones with tracheomalacia). CTS length ranged from 8 to 65 mm. The causes of invasive mechanical ventilation were traumatic brain and spinal trauma in 6 cases, emergency surgery in 11 cases and therapeutic diseases in 29 cases. CTS of cervical trachea was found in 21 patients, subglottic larynx and cervical trachea — 8 patients, cervical and upper thoracic trachea — 12 patients, thoracic segment — 3 patients, multifocal lesions — 2 patients. The Charlson index ranged from 5 to 12 points. ASA grade II was observed in 8 (17.4%) patients, III — 28 (60.9%), IV — in other ones. Circular resection was performed in 5 patients, laryngotracheoplasty — in 37 patients. CTS repair and tracheoesophageal fistula closure with laryngotracheoplasty were carried out in 2 patients. Postoperative complications occurred in 18 (39.1%) patients, mortality was 2.17%. In 21.7% of cases, complications were associated with tracheal suture. Endoscopic procedures, cryosurgery and hyperbaric oxygenation were used for correction. Good and satisfactory treatment outcomes were achieved in 86.5% of patients.

CONCLUSION

Surgical treatment of CTS in elderly and senile patients requires participation of interdisciplinary team with special experience. Laryngotracheoplasty is safe and effective in these patients, and indications for circular resection are still limited.

Keywords:

cicatricial tracheal stenosis

tracheoesophageal fistula

tracheal resection

laryngotracheal reconstruction

elderly and senile patients

Authors:

Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
National Research Tomsk State University

SPIN RSCI: 6744-9541
Scopus AuthorID: 35197267200
ResearcherID: T-5818-2018
ORCID: 0000-0002-5674-0177

Tsydenova A.N.

Siberian State Medical University;
Tomsk Regional Clinical Hospital

ORCID: 0000-0001-6670-9010

Received:

16.01.2023

Accepted:

11.02.2023

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