Surgical treatment of tracheal stenosis

INTRODUCTION: Surgical treatment of tracheal stenoses (TS) using tracheal resection (TR) is a treatment modality that should be considered in every case. We report the results from TR in a consecutive series of 17 patients in Western Denmark during the past five years. MATERIAL AND METHODS: A total of 32 patients with TS were retrospectively evaluated, of whom 17 underwent TR with end-to-end anastomoses. Age, gender, aetiology, symptoms, findings, localisation and length of the stenoses were registered. In addition, other procedures than TR and patient satisfaction were registered. RESULTS: Nine (53%) and three (18%) had post-tracheostomy and post-intubation stenoses, three (18%) had an intraluminal tumour, two (12%) had amyloidosis and sequelae after fracture of a tracheal ring, respectively. Prior to surgery, 29% underwent stent implantation, 41 and 47%, respectively, had had laser resection and/or dilation a number of times. The median stenosis length was 1.1 cm (0.4-2.0 cm), and they were primarily located 2-4 cm below the vocal cords. The length of resection ranged from 2.0 to 3.5 cm (median 2.3). Postoperatively, one (5.8%) patient died and one needed reoperation due to haematoma, none developed insufficient anastomosis and of those with preoperative permanent tracheal tube, all but one could do without the tube after surgery. The follow-up period was 3.0 years (0.0-5.5 yrs). 75% was - according to questionnaire answers - very satisfied with the result, 25% were moderately satisfied. CONCLUSION: The results from surgical treatment of TS in Denmark are in line with international studies and TR is the treatment of choice in selected patients with TS.