Tracheal Resection and Reconstruction: Predictors of Postoperative Tracheal Restenosis

Shalaby, Gamal M.; Abdallah, Ahmed K.; Elgamal, Mohamed-Adel F.; Sabri, Rami A.

doi:10.21608/ejhm.2022.270822

Tracheal Resection and Reconstruction: Predictors of Postoperative Tracheal Restenosis

Document Type : Original Article

Authors

10.21608/ejhm.2022.270822

Abstract

Background: Tracheal resection and reconstruction (TRR) is a highly challenging mission to any tracheal surgery group. New advances in tracheal surgery declared by Barclay when first trial of tracheal resection and reanastomosis was performed. After that, trials began to allow more tracheal segment to be resected.
Aim: It was to determine predictors of postoperative tracheal restenosis.
Patients and Methods: This retrospective study was conducted on twenty-four patients who underwent TRR that done in Cardiothoracic Surgery Department, Mansoura University Hospital from January 2014 till July 2022. Inclusion criteria included patients with tracheal stenosis of any age, of both sexes, and patients with benign or malignant tumors. Exclusion criteria included immunocompromised patients, diffuse tracheal stenosis, and autoimmune tracheal lesions or tracheal stenosis less than 50% of normal tracheal diameter.
Results: Restoration of normal airway continuity was succeeded in 20 cases (83.3%) and failed in 4 cases (16.7%); 3 cases (75%) due to restenosis and one case (25%) due to anastomotic dehiscence due to epileptic fit. Three cases needed postoperative stenting; one (33.3%) showed good result, one (33.3%) complicated by stent migration, and the last case (33.3%) needed stent removal through anterior tracheotomy and permanent tracheostomy.
Conclusion: Early and regular follow-up visits for patients with prolonged mechanical ventilation after discharging home, ensuring good preoperative preparations for patients with epilepsy with 6 months convulsion free period before surgery and avoiding usage of unipolar diathermy for lateral tracheal dissection could decrease postoperative tracheal restenosis for patients’ undergone tracheal resection and reconstruction.

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