Long-term outcomes of surgical management in post-intubation tracheal stenosis: a retrospective analysis of tracheal resection and reconstruction.

Autor: Ulusan A; Department of Thoracic Surgery, Faculty of Medicine, Gaziantep University, 27310, Gaziantep, Turkey. draulusan@gmail.com., Tunca IE; Department of Thoracic Surgery, Faculty of Medicine, Gaziantep University, 27310, Gaziantep, Turkey., Elma B; Department of Thoracic Surgery, Faculty of Medicine, Gaziantep University, 27310, Gaziantep, Turkey., Sanli M; Department of Thoracic Surgery, Faculty of Medicine, Gaziantep University, 27310, Gaziantep, Turkey., Isik AF; Department of Thoracic Surgery, Faculty of Medicine, Gaziantep University, 27310, Gaziantep, Turkey.
Jazyk: angličtina
Zdroj: Updates in surgery [Updates Surg] 2024 Nov 23. Date of Electronic Publication: 2024 Nov 23.
DOI: 10.1007/s13304-024-02040-w
Abstrakt: Post-intubation tracheal stenosis (PITS) is a serious complication of prolonged intubation, often requiring surgical intervention. This study aims to present the long-term outcomes of patients with PITS who underwent tracheal resection and reconstruction, as well as to discuss the efficacy of these surgical methods in comparison to stenting. This retrospective study included patients treated for PITS at our center between October 2005 and October 2022. Patients were divided into two groups: those who underwent tracheal resection and reconstruction (n = 29) and those treated with stenting (n = 47). The clinical characteristics, surgical techniques, complications, and long-term outcomes were recorded and analyzed. The mean age of the patients was 41.3 years, with 40.0% aged between 40 and 60 years. The mean intubation duration was 16.8 days. In the resection group, 22 of 29 patients (75.8%) showed no recurrence or complications during long-term follow-up. The overall success rate for surgical treatment was 93.1%, with a mortality rate of 6.8%. In the stenting group, successful stent removal was achieved in 9 of 47 cases, with a mean stent removal time of 26 months. Granulation tissue formation and restenosis were more frequently observed in stented patients compared to those who underwent surgery. Tracheal resection and end-to-end anastomosis remain the gold standard treatment for PITS, with a lower recurrence rate and fewer long-term complications compared to stenting. However, stenting may be a viable option for patients who are not suitable candidates for surgery. Careful preoperative evaluation and long-term follow-up are essential to optimize patient outcomes.
Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflict of interests. Ethical approval and consent to participate: The study was approved by the Institutional Ethics Committee and conducted in accordance with the ethical guidelines of the Helsinki Declaration. Informed consent was obtained from all the patients or their families. As a retrospective and observational study, our study approved by the Clinical Ethics Committee of the Gaziantep University (Approval date: 01/02/2023 and Approval no: 2022/348). Informed consent: Informed consent was obtained from all subjects involved in the study.
(© 2024. Italian Society of Surgery (SIC).)
Databáze: MEDLINE
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