Tratamiento quirúrgico de la estenosis traqueal

Objective: To present the result of a series of cases of tracheal stenosis surgically treated by means of tracheoplasty during five years at a public hospital in Mexico City. Place: Third-level attention hospital. Design: Retrospective, observational and transversal study. Statistical analysis: Percentages as a measure of qualitative variables. Material and methods: It was analyzed every operated case during the period going from January 1st 2003 to December 31st 2007 with a diagnosis of acquired or congenital tracheal and operated through tracheoplasty. The diagnosis was obtained by respiratory endoscopy and complementary studies that included bronchography, axial computed tomography (CAT scan) and/or magnetic resonance imaging (MRI) from neck/thorax, as well as pulmonary function tests. There were three groups according to the stenosis magnitude: Type I (soft), Type II (mild) and Type III (severe or serious) with a specific treatment for each kind of stenosis. The evaluated variables were age, gender, etiology, localization, type of stenosis, clinical groups, associated abnormalities, complications, type of medical treatment –endoscopic or surgical– used surgical technique or endoscopy, follow-up period, and final result. Results: From a total of 50 patients with a diagnosis of tracheal stenosis, 25 (50%) of them were prospects for the surgical treatment. The average age was of 35.6 years (ranging from 15 to 64); there were 26 (52%) men and 24 (48%) women. The principal etiology was endotracheal intubation in 42 patients (84%), followed by tracheal granuloma (8%), obliterating stenosing tracheitis (4%), and bronchogenic endotracheal cancer secondary to extrinsic obResumen Objetivo: Presentar los resultados de una serie de casos de estenosis traqueal tratados quirurgicamente mediante plastia de traquea durante 5 anos en un Hospital Publico de la Ciudad de Mexico. Sede: Hospital de tercer nivel de atencion. Diseno: Estudio retrospectivo, observacional y transversal. Analisis estadistico: Porcentajes como medida de variable cualitativa. Material y metodos: Se analizaron todos los casos operados en el periodo del 1o de enero de 2003 al 31 de diciembre de 2007 con diagnostico de estenosis traqueal adquirida o congenita y operados mediante plastia traqueal. El diagnostico se establecio mediante endoscopia respiratoria y estudios complementarios que incluyeron broncografia, tomografia axial computada y/o resonancia magnetica de cuello-torax, asi como pruebas de funcion pulmonar. Se conformaron tres grupos de acuerdo a la magnitud de la estenosis: Tipo I (leve), Tipo II (moderada) y Tipo III (severa) con tratamiento especifico para cada tipo de estenosis. Las variables evaluadas fueron: edad, genero, etiologia, localizacion, tipo de estenosis, grupos clinicos, anomalias asociadas, complicaciones, tipo de tratamiento medico, endoscopico y/o quirurgico, tecnica quirurgica o endoscopica utilizada, tiempo de seguimiento y resultado final. Resultados: De un total de 50 pacientes con diagnostico de estenosis de traquea, 25 fueron candidatos a tratamiento quirurgico (50%). La edad promedio fue de 35.6 anos (rango de 15 – 64), 26 hombres (52%) y 24 mujeres (48%). La principal etiologia fue la intubacion endotraqueal en 42 pacientes (84%), seguida de granuloma traqueal (8%), traqueitis obliterante estenosante (4%), por cancer www.medigraphic.org.mx