MULTIDISCIPLINARY TREATMENT OF BENIGN CENTRAL AIRWAY STENOSES POST INTUBATION

Abstract

Introduction: Postintubation laryngotracheal stenoses are lesions of a benign and progressive nature that pose a challenge to the treatment team. The narrowing of the airway lumen is responsible for increasing dyspnea, which requires rapid and effective diagnosis and treatment methods. This is why it is essential to approach this condition by a multidisciplinary team including thoracic surgeons, bronchoscopists and intensivists.
Objective: To evaluate the results obtained with the surgical treatment of patients with laryngotracheal stenosis previously selected according to the algorithm in a specific
period and their complications.
Material and methods: The medical records of 57 patients with laryngotracheal stenosis were studied observationally and retrospectively between the years 1996 and 2023, and they were included for surgical treatment: 5 were laryngotracheal and 52 were tracheal. Resection and reconstruction were performed according to the Pearson technique in the first group, and resection with tracheotracheal anastomosis was used in the second group.
Results: Of the total 57 operated patients, 48 had a good postoperative evolution and 9 showed  complications, which corresponds to 15.7% of the total. 4 air fistulas and 5 restenosis of the anastomosis were observed. There was no mortality in our series of patients.
Conclusions: Surgery is the best therapeutic option in strictly selected patients with
laryngotracheal lesion, a fact corroborated by our experience and the literature. The multidisciplinary approach allows for better diagnostic and therapeutic evaluation, since interventional bronchoscopy allows us to dilate and take patients to surgery in better clinical conditions.