Outcomes of tracheal resection and anastomosis for post intubation tracheal stenosis: a study of 12 cases

Abstract

Post intubation tracheal stenosis is a severe clinical condition with an increasing prevalence due to the advances of critical care medicine. This is a retrospective study including 12 cases of post-intubation tracheal stenosis managed by TRA in our head and neck surgery department between the years 2013 and 2019. All patients underwent preoperative clinical evaluation based on neck CT scan and endoscopy under general anaesthesia. Traffic road accidents and trauma were the main causes of prolonged intubation. Ten (10) patients required tracheostomy. According to the Cotton Meyer grading, 4 patients had grade II, 2 had grade III and 4 had grade IV. The mean length of stenosis was 16.2±5.6 millimeters. T-tube was inserted intraoperatively in 5 patients. 4 were successfully decannulated in a mean delay of 9.2 months. Early postoperative complications were subcutaneous emphysema, laryngeal edema, aspiration pneumonia, intra-tracheal migration of the T-tube, and vocal cord paralysis each complication occurred in 1 case. Late postoperative complications were granulation tissue formation observed in 5 cases and restenosis in 3 cases. The initial success rate of the TRA was 91.7%. Management of Post intubation tracheal stenosis requires a skillful multidisciplinary team. TRA guided by a meticulous preoperative evaluation is the gold standard. Keywords: tracheal resection, anastomosis, tracheal resection with end-to-end anastomosis, cervical computed tomography