Tracheal stenosis after intubation and/or tracheostomy

Abstract

Introduction: The tracheal iatrogenic stenosis remains a frequent, sometimes severe tracheal resection, anastomosis is the treatment of choice. However, the endoscopic treatment is used as an alternative therapy. Materials and methods: We report a retrospective study for a period of 8 years. Results: 174 patients had an iatrogenic tracheal stenosis of intubation (55.17%) and/or tracheotomy (44.82%). The appearance and extent of stenosis were assessed by bronchoscopy, we noted a tracheal malacia (15%), a circumferential stenosis (58%), a little tight stenosis (12%) and diaphragm (5%). Some patients have benefited from several therapeutic procedures, 90 patients were operated on early interventions with 53 and 37 after surgery, an improvement of the patient’s clinical status have been postponed earlier, after failure of endoscopic methods. 293 interventional bronchoscopies were performed, 192 stenting, 45 Nd-YAG laser, 55 patients required a recalibration in the tube of the bronchoscope and one patient received cryotherapy, knowing that there are the patients who received combination therapy. We lamented death in the immediate postoperative sepsis, a recurrence of stenosis in 117 patients, and among the 192 implants placed we identified 37 migrations, 52 congestion, development of granulomatous lesions, an overhaul of the prosthesis is noted in 7.29%, three implants were embedded in the tracheal mucosa and there was only one spontaneous rejection. The long-term evolution was satisfactory in 92 patients. Conclusion: Nevertheless, the management of post intubation tracheal stenosis and/or post tracheostomy cannot be that requiring a multidisciplinary collaboration.

Keywords

• Bronchoscopy
• Intubation
• Surgical
• Laser
• Prosthesis
• Trachea
• Stenosis