Tracheal resection after prolonged stenting in surgery for cicatricial stenosis

V.D. Parshin

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

M.A. Rusakov

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

V.V. Parshin

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

D.M. Amangeldiev

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

A.V. Parshin

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

R.Yu. Maer

Moscow city health department, Moscow, Russia

Tracheal resection after prolonged stenting in surgery for cicatricial stenosis

Authors:

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

More about the authors

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

DOI: 10.17116/hirurgia20191115

Downloaded: 39

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

Доказательная гастроэнтерология: pro et contra

Актуальные вопросы педиатрической практики

Использование инфографики авторами научных работ

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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:

V.D. Parshin

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

M.A. Rusakov

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

V.V. Parshin

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

D.M. Amangeldiev

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

A.V. Parshin

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

R.Yu. Maer

Moscow city health department, Moscow, Russia

List of references:

Mosin IV, Sanginov AB, Bazhanov AA. Kompleksnoye lecheniye protyazhennykh rubtsovykh stenozov verkhney treti trakhei. Khirurgiya. 2011;(2):37-39. (In Russ.)
Ovchinnikov AA, Seredin RV. Primeneniye endostentov pri opukholevykh i rubtsovykh stenozakh trakhei i glavnykh bronkhov. Vestnik otorinolaringologii. 2004;(2):23-28. (In Russ.)
Parshin VD, Porkhanov VA. Khirurgiya trakhei s atlasom operativnoy khirurgii. M.: Meditsina Al’di print, 2010. (In Russ.).
Perelman MI. Khirurgiya trakhei. M.: Meditsina, 1972. (In Russ.)
Rusakov MA, Parshin VD, Elezov AA. Sovremennyye metody endoskopicheskogo lecheniya rubtsovykh stenozov trakhei. Problemy tuberkuloza i bolezney logkikh. 2006;(3):11-13. (In Russ.)
Rusakov MA, Parshin VD, Sharipzhanova RD, Kochneva ZV. Endoskopicheskoye lecheniye yatrogennykh rubtsovykh stenozov trakhei. Klinicheskaya endoskopiya. 2013;3(41):28-36. (In Russ.)
Sanginov AB, Mosin IV, Bazhanov AA. Kompleksnoye lecheniye protyazhennykh rubtsovykh stenozov verkhney treti trakhei. Khirurgiya. 2011;(2):37-39. (In Russ.)
Skvortsov MB, Makhutov VN, Kurgansky IS, Inozemtsev EO. Tsirkulyarnaya rezektsiya pri rubtsovom stenoze trakhei. Sibirskiy meditsinskiy zhurnal (Irkutsk). 2016;(3):6-9. (In Russ.)
Starkov YuG, et al. Endoskopicheskoye stentirovaniye trakhei pri rubtsovykh stenozakh s tsel’yu podgotovki k khirurgicheskomu lecheniyu. Khirurgiya. 2013;(8):15-17. (In Russ.)
Folomeev VN, Sotnikov VN, Sotnikov AV and collaborators. Diagnostika i lecheniye bol’nykh s ostrymi postintubatsionnymi i posttrakheostomicheskimi stenozami gortani i trakhei. Vestnik otorinolaringologii. 2002;(5):25-27. (In Russ.)
Kharchenko VP, Chkhikvadze VD, Bryusov PG. Rekonstruktsiya i plastika trakhei posle obshirnykh rezektsiy. Khirurgiya. 1983;(4):19-23. (In Russ.)
Chernekhovskaya NV. Sovremennyye tekhnologii v endoskopii. M.:RMAPO, 2004. (In Russ.)
Abbasidezfouli A, Shadmehr MB, Arab M, et al. Postintubation multisegmental tracheal stenosis: treatment and results. Ann Thorac Surg. 2007 Jul;84:211-214.
Bonnette P, Colchen A, Leroy M, Bisson A. Tracheal resection-anastomosis for iatrogenic stenosis. Experience in 340 cases. Rev Mal Respir. 1998;15(5):627-632.
Couraud L, et al. Iatrogenic stenoses of the respiratory tract. Evolucion of therapeutic indicacions. Baset on 217 surgical cases. Ann Surg. 1994;48(3):277-283.
Grillo HC. Surgery of the trachea and bronchi. London: BC Decker Inc Hamilton. 2004.
Zhestkov KG, Barsky BV, Savelyeva NS. Stentirovaniye kak metod lecheniya stenozov trakhei. TMJ. 2011;(4):46. (In Russ.)
Muravev VYu, Khasanov RSh, Ivanov AI. Stentirovaniye kak metod lecheniya stenozov trakhei i ezofago-respiratornykh fistul. Endoskopiya. Endokhirurgiya. Onkologiya. 2008;(2):22-24. (In Russ.)
Yaitsky NA, Gerasin VA, Gerasin AV, Rusanov AA. Rol’ endoskopicheskikh metodov v lechenii trakheal’nykh rubtsovykh stenozov trakhei. Vestnik khirurgii im. Grekova. 2012;171(3):11-15. (In Russ.)
Cavaliere S. Management of post-intubation tracheal stenoses using the endoscopic approach. Monaldi Arch Chest Dis. 2007 Jun;67(2):73-80.
Charokopos N. The management of post-intubation tracheal stenoses with self-expandable stents: early and long-term results in 11 cases. Eur J Cardiothorac Surg. 2011 Oct;40(4):919-924.
Dumon JF. A dedicated tracheobronchial stent. Chest. 1990;97(2):328-332.
Gorbunov VA. Rekonstruktivnaya khirurgiya povrezhdeniy gortani i sheynogo otdela trakhei. Dissertation of the doctor of medical sciences. 1999. (In Russ.)
Kirasirova EA, Karimova FS, Kabanov VA, Lafutkina NV, Khamzalieva RB. Terapevticheskiy algoritm pri stenozakh gortani i sheynogo otdela trakhei razlichnoy etiologii. Vestnik Otorinolaringologii. 2006;(2):20-24. In Russ.).
Kirasirova EA, Mukanova ZT, Khurshidov FN. Sovremennyye metody diagnostiki i khirurgicheskogo lecheniya bol’nykh stenozom gortani i trakhei razlichnoy etiologii. Vestnik KazNMU. 2015;2. (In Russ.)
Zenger VG, Nasedkin AN, Parshin VD. Khirurgiya povrezhdeniy gortani i trakhei. M.: Meditsina, 2007. (In Russ.)
Kozlov KK, Korzhuk MS, Sitnikova VM, Kralya IV. Klinicheskaya otsenka razlichnykh metodov lecheniya stenozov trakhei. Problemy tuberkuloza i bolezney logkikh. 2006;(3):23-28. (In Russ.)
Nazyrov FG, Khudaibergenov SN, Eshonhodzhaev OD, Irisov OT, Tursunov NT, Rizaev EA, Mustaev AT. Neposredstvennyye i otdalennyye rezul’taty stentirovaniya trakhei pri rubtsovykh stenozakh. Byulleten’ fiziologii i patologii dykhaniya. 2014;53. (In Russ.)
Massard G, Rouge C, Dabbagh A, et al. Tracheobronchial lacerations after intubation and tracheostomy. Ann Thorac Surg. 1996;61:1483-1487.
Rusakov MA, et al. Prichiny oslozhneniy endoskopicheskogo endoprotezirovaniya pri rubtsovom stenoze trakhei. 14 Moskovskiy mezhdunarodnyy kongress endoskopicheskoy khirurgii. 2010:304-310. (In Russ.)

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