Surgical treatment of tracheal stenoses in an emerging country

Abstract

*Surgical treatment is one of the main therapeutic alternatives for tracheal stenosis. We report the results of surgical treatment for tracheal stenosis in a Tunisian university center. *Retrospective descriptive study of 45patients who underwent surgery for tracheal stenosis between January2020 and December2023. *The average age was 32years old[4-73] with a M/F sex ratio of2.75. All of our patients were intubated and the average duration of the intubation was 15days[3-50]. Tracheostomy was necessary in 13cases. The Stenosis was idiopathic in 2 cases. Dyspnea was the main symptom(41patients). Wheezing was noted in 14patients. The average time to onset of symptoms was 39days[1-730]. Bronchial endoscopy was performed in 12patients. The average tracheal diameter reduction was 67.7%[40-92]. The average length of tracheal stenosis was 19.9mm[4-50]. The average distance between the glottis and the stenosis was 32mm[0-86]. Endoscopic treatment was performed in 6patients. The most used approach was a horizontal cervicotomy(42patients). Right posterolateral thoracotomy was used in 2patients and vertical median sternotomy in 1patient. The procedure consisted on tracheal resection and trachea-tracheal anastomosis in 43cases and cricotracheal anastomosis in 2cases. The average length of the resected trachea was 30mm[10-60]. The average operating time was 100minutes[40-200]. The average drainage time was 2.8days[1-8]. The post-operative course was uneventful for 34cases, complicated for 11. Five local recurrences were noted. *The treatment of tracheal stenosis is multidisciplinary and the surgery gives a good long-term result. A rigorous technique is imperative in order to try to avoid the occurrence of post-operative complications