Surgical management of patients with post-entubation tracheal stenosis (PETS): A single center experience

Abstract

Post-entubation tracheal stenosis(PETS) is observed in patients who are hospitalized in the intensive care unit due to various etiological reasons and who are exposed to prolonged intubation during follow-up as a result of the pressure applied to the tracheal mucosa to cause necrosis or scarring in the trachea. In our study,we aimed to retrospectively evaluate the results of patients who underwent dilatation with rigid bronchoscopy and those whose conditions did not improve despite dilatation and underwent tracheal resection and reconstruction, and compare the with the literature. This study was conducted to retrospectively analyze the data of 20 patients who underwent surgical intervention due to PETS between 2019-2022.The patients were divided into 2 groups according to the Cotton Myer PETS index of the data obtained as a result of measuring the diameter of the stenotic tracheal segment according to bronchoscopic and CT measurements. When the patients were classified according to the post-intubation tracheal stenosis classification described by Cotton Myer,it was seen that 7 patients were Grade 1.10 patients were Grade 2 and 3 patients were Grade 3. Tracheal resection and reconstruction surgery is a difficult procedure and requires surgical experience due to the lack of experienced anesthesia team in every center.For this reason,we recommend sequential bronchoscopic dilatation in patients with comorbidity who are not suitable for tracheal resection and in grade 1 patients. However, we suggest that tracheal resection and reconstruction surgery should be performed after appropriate preoperative preparation in patients with grade 2 and 3 without comorbidity. [Med-Science 2022; 11(4.000): 1711-4]

Keywords

• post-entubation tracheal stenosis (pets)
• bronchoscopic dilatation
• tracheal resection