Results of Surgical treatment for postintubation airway stenosis, in 901 patients

ABSTRACT

Although resection and anastomosis [RA] is known as most efficient method for treatment of post-intubation airway stenoses, non-resectional methods are being developed and suggested as substitutes for RA. Presenting our experience with sufficient number of patients who underwent resection might be helpful in comparison and selection of various treatment methods. All patients who had been referred to us [Feb 1994 to Jan 2007] underwent bronchoscopy and evaluation of the stricture and function of the larynx. Patients in good general condition whose strictures were operable by RA underwent this operation. Other patients underwent non-resectional treatments. Three types of operations were performed 1] tracheal resection 2] resection of trachea and anterior arch of cricoid 3] resection of trachea and anterior arch of cricoid associated with posterior cricoidotomy and autologous cartilage grafting at the site of cricoidotomy. Surgical results were categorized into good, acceptable and failure. Results were analyzed using SPSS software with Chi-square and Fisher's exact tests. Nine hundred one patients underwent treatment during 13 years out of which, 571 underwent RA [420 men, 151 women, mean age 25.6 yrs]. Types 1, 2 and 3 operations were performed on 451, 88 and 32 patients, respectively. Results were good in 434 [76.10%], acceptable in 79 [13.84%] and failure in 53 [9.29%] patients. Thirteen deaths occurred after resectional treatment and 25 deaths after non-resectional treatments. Single-stage resection and anastomosis is an appropriate treatment for most cases of post-intubation tracheal and laryngotracheal stenoses