SURGICAL TREATMENT OF RECURRENT TRACHEAL STENOSIS AFTER SURGERY

Abstract

*Surgery for tracheal stenosis is one of the main therapeutic weapons but it can be complicated. Redo surgery may be an effective alternative. *Among the 45 patients operated on for tracheal stenosis during the study period, recurrence was noted in 5 patients. The recurrence appeared after 2months in average[1-3]. The average age was 37years old[15-48] with a M/F sex ratio of1.5. All of our patients were intubated and the average duration of the intubation was 17days[5-36]. Tracheostomy was necessary in 2cases. Dyspnea was the main symptom(5patients). The average time to onset of symptoms was 42days[1-150]. Bronchial endoscopy was performed in 1patient. In CT-scan, the average tracheal diameter reduction was 65%[50-70] and the average length of tracheal stenosis was 10mm[8-10]. The average distance between the glottis and the stenosis was 18mm[10-38]. The procedure consisted on tracheal resection and trachea-tracheal anastomosis in all cases. The average length of the resected trachea was 1.2mm[1-1.5](VS 3mm[2-6] for the first resection). The average operating time was 108minutes[80-165] (VS 106minutes [75-170] for the first resection).. All patients had a "guardian" chin at the end of the procedure. All patients were systematically treated with antibiotics postoperatively. The average drainage time was 3days[2-5] (VS 3days[2-5] for the first resection).. The post-operative course was uneventful for all patients. The average hospital stay was 6days[5-10] (VS 6days[4.8] for the first resection). No local recurrences were noted. *Redo surgery for recurrence of tracheal stenosis is certainly complex but allows definitive resolution of the tracheal damage. It requires rigorous surgical technique and a certain experience.