Analysis of 40 patients who underwent tracheal resection due to benign complex tracheal stenosis.
Anastomotic complications
Tracheal resection
Tracheal stenosis
Journal
Asian journal of surgery
ISSN: 0219-3108
Titre abrégé: Asian J Surg
Pays: Netherlands
ID NLM: 8900600
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
18
03
2021
revised:
19
04
2021
accepted:
29
04
2021
pubmed:
31
5
2021
medline:
6
1
2022
entrez:
30
5
2021
Statut:
ppublish
Résumé
Benign tracheal stenosis is a common complication in patients followed up in intensive care units. We aimed to analyze the etiology, diagnostic approaches, treatment methods for benign tracheal stenosis, and the predicting factors for complications after tracheal resection for benign stenosis. Forty patients who underwent tracheal resection reconstruction due to benign tracheal stenosis were analyzed retrospectively. Predictive factors for complications were determined by statistical analysis. There were 23 patients (57.5%) in the intubation group, 11 patients (27.5%) in the tracheostomy group, and 6 patients (15%) in the subsequent tracheostomy group. Preoperatively, rigid dilatation was applied to all patients between 2 and 6 sessions (median = 3). Tracheal resections were performed in all patients after rigid dilatations. The mean of the resected segment lengths is 32.1 ± 8.8 mm. There was a statistically significant difference between preoperative bronchoscopic measurements, preoperative tomography measurements, and intraoperative measurements of the stenosis segment (ꭓ2 (2) = 71,500; p < 0.001). The patients' mean follow-up period was 27.4 ± 21.7 months (3-84). Mortality due to tracheal surgery and major anastomotic complications were not observed. The minor anastomotic complication rate was 12.5%, the non-anastomotic complication rate was 17.5%. The effect of resection length and surgical experience were found to be statistically significant risk factors for anastomotic complications. Rigid dilatation does not provide significant palliation in complex stenosis. Bronchoscopic measurements give closer results than CT measurements in the preoperative estimation of resection length. The risk of anastomotic complications increases when the length of the resection increases and when the surgical experience is less.
Sections du résumé
BACKGROUND
BACKGROUND
Benign tracheal stenosis is a common complication in patients followed up in intensive care units. We aimed to analyze the etiology, diagnostic approaches, treatment methods for benign tracheal stenosis, and the predicting factors for complications after tracheal resection for benign stenosis.
MATERIAL-METHOD
METHODS
Forty patients who underwent tracheal resection reconstruction due to benign tracheal stenosis were analyzed retrospectively. Predictive factors for complications were determined by statistical analysis.
RESULTS
RESULTS
There were 23 patients (57.5%) in the intubation group, 11 patients (27.5%) in the tracheostomy group, and 6 patients (15%) in the subsequent tracheostomy group. Preoperatively, rigid dilatation was applied to all patients between 2 and 6 sessions (median = 3). Tracheal resections were performed in all patients after rigid dilatations. The mean of the resected segment lengths is 32.1 ± 8.8 mm. There was a statistically significant difference between preoperative bronchoscopic measurements, preoperative tomography measurements, and intraoperative measurements of the stenosis segment (ꭓ2 (2) = 71,500; p < 0.001). The patients' mean follow-up period was 27.4 ± 21.7 months (3-84). Mortality due to tracheal surgery and major anastomotic complications were not observed. The minor anastomotic complication rate was 12.5%, the non-anastomotic complication rate was 17.5%. The effect of resection length and surgical experience were found to be statistically significant risk factors for anastomotic complications.
CONCLUSIONS
CONCLUSIONS
Rigid dilatation does not provide significant palliation in complex stenosis. Bronchoscopic measurements give closer results than CT measurements in the preoperative estimation of resection length. The risk of anastomotic complications increases when the length of the resection increases and when the surgical experience is less.
Identifiants
pubmed: 34052083
pii: S1015-9584(21)00257-8
doi: 10.1016/j.asjsur.2021.04.040
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
213-219Informations de copyright
Copyright © 2021. Published by Elsevier Taiwan LLC.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no conflict of interest.