Tracheal resection with end-to-end anastomosis for isolated cervical tracheal stenosis.

Abstract

Background : Despite the improvement of intubation managements, laryngotracheal injuries, leading to subsequent serious morbidities such as tracheal stenosis etc. are still present and remain therapeutic challenge.

Objective : To study our experiences in solving the problem of isolated cervical tracheal stenosis by tracheal resection with primary anastomosis at a sub-tertiary regional medical center base by 4 Otolaryngologists .

Method : We retrospectively studied a consecutive series of 17 adult patients underwent the surgical interventions from 1988-2005. There were 13 males and 4 females with the range of 16-56 years old, and had isolated circumferential stenosis of more than 70 percent. The average resected length was 3.26cm.(range 2.5-4.5 cm.). All the patients were managed under the same operative technique and care map which were discussed. The managements of complications by the available means were also mentioned.

Results : Eleven cases(64.7 percent) got satisfied results. Five cases(29.4 percent) needed further endoscopic dilations ± steroid injections (range 1-6 procedures). One case(5.9 percent) needed re-tracheostomy, dilations, steroid injections and Mitomycin-C applications, and could be decannulated eventually. There were no other serious complications but a short period(less than 8 weeks) of postoperative dysphagia in 4 cases(23.5 percent). The follow-up time ranged 1-60 months, All did well on their last visits. Neither laryngeal dysfunction nor mortality in our series.

Conclusion : Tracheal resection with end-to-end anastomosis is a relatively safe and reliable procedure, when ever possible, for isolated cervical tracheal stenosis

Key words : Cervical tracheal stenosis, Tracheal resection, End-to-end anastomosis