Tracheal re-stenosis after resection and anastomosis of complete tracheal stenosis

ABSTRACT

@#Tracheal stenosis is a difficult complication to treat. It begins as a complication and eventually becomes serious enough to compromise the airway, leading to surgery. The treatment of complete tracheal stenosis is resection with tracheal end-to-end anastomosis.1 The incidence of tracheal re-stenosis following anastomosis is relatively high at about 10.5% for Caucasians.2 We are not aware of any studies on the incidence of this condition in the Philippines. In airway management, endotracheal intubation is the initial choice to secure the patient’s airway, followed by tracheostomy tube insertion. Both modalities require proper weaning for eventual decannulation. If decannulation has failed, the possibility of tracheal stenosis as a complication must be considered and investigated. In cases of re-stenosis after tracheal resection and anastomosis, what to do next is a challenge. Should another surgery for resection be planned? Will there be any changes in the technique of the surgery or additional medical treatment? Answering these questions may guide the surgeon’s next move and prevent re-stenosis and ultimately lead to decannulating the patient. We present a case of tracheal re-stenosis following two separate tracheal resections and end-to-end anastomosis procedures.