Abstrakt
Benign tracheal stenosis is difficult to treat and management of this is still debated. The results of a study assessing effectiveness of the combined therapy are presented here.
We evaluated the effect of treatment of 52 patients with 54 cases of benign stenosis of central airways which developed after or during the oro-tracheal intubation in 44 patients and as a consequence of other diseases in 8 patients. All patients but one underwent rigid bronchoscopy with dilatation, and electrocautery or Nd-YAG laser desobliteration.
Stenosis did not recur in 22 patients (42%). Surgical resection was indicated in 25 patients with post-intubational tracheal re-stenosis.
Five patients were inoperable and remained dependent on permanent tracheostomy. 25 patients underwent surgery. The stenosis reappeared in two of them (8%) and they had to be re-operated.
We introduced 14 stents to 10 patients. We conclude that the interventional bronchoscopy was successful in 42% of patients with benign tracheal stenosis.
Surgery succeeded in 92% of those who underwent tracheal resection. Whenever possible, after preliminary desobliteration of the central airways using interventional bronchoscopy, surgery should be considered as the most effective treatment.