Kumar Arvind, Asaf Belal Bin, Puri Harsh Vardhan, Abdellateef Amr
Department of Thoracic Surgery, Institute of Robotic Surgery, Sir Ganga Ram Hospital, New Delhi, India.
Department of Thoracic Surgery, Sir Ganga Ram Hospital, New Delhi, India.
Lung India. 2017 Sep-Oct;34(5):420-426. doi: 10.4103/0970-2113.213834.
Tracheal stenosis is a complex condition caused by altered inflammatory response to injury and subsequent excessive circumferential scar formation. Surgical resection, wherever possible, offers the best long-term results. Nonsurgical methods provide immediate relief to all can be curative in few but mostly serve as an excellent bridge to surgery in majority. The purpose of this study is to retrospectively evaluate the outcome following surgery for benign tracheal stenosis at our center.
This retrospective analysis was conducted on 18 patients who underwent resection and anastomosis for tracheal stenosis at our center between March 2012 and December 2015. Their records were analyzed for demography, history, clinical presentation, computed tomography, bronchoscopy details, preoperative interventions, indications for and details of surgery, the procedure performed, postoperative complications, and course during 6 months follow-up.
The patients had a varied list of pathologies for which they were either intubated or tracheostomized. The length of stenosis ranged between 1 cm and 4 cm. The diameter of stenotic segment ranged between 0 mm and 10 mm. Average length of resected segment was 3 cm, and number of tracheal rings resected ranged from 2 to 9. Postoperative complications occurred in four patients (22.22%). All our patients were in the "excellent outcome" category at discharge as well as at 3 months follow-up.
Surgical management of tracheal stenosis is challenging and requires multidisciplinary team approach. Thorough preoperative preparation and multidisciplinary planning regarding need for and timing of surgery, meticulous intraoperative technique, and aggressive postoperative care is key to successful surgery, which can provide long-lasting cure to these patients.
气管狭窄是一种复杂的病症，由对损伤的炎症反应改变以及随后过度的环形瘢痕形成所致。只要有可能，手术切除可提供最佳的长期效果。非手术方法能立即缓解症状，少数情况下可治愈，但多数情况下主要作为大多数患者手术的理想过渡手段。本研究的目的是回顾性评估我院中心良性气管狭窄手术后的结果。
对2012年3月至2015年12月期间在我院中心接受气管狭窄切除及吻合术的18例患者进行了这项回顾性分析。分析了他们的记录，包括人口统计学、病史、临床表现、计算机断层扫描、支气管镜检查细节、术前干预措施、手术指征及细节、所实施的手术步骤、术后并发症以及6个月随访期间的病程。
这些患者因各种不同的病症接受了插管或气管造口术。狭窄长度在1厘米至4厘米之间。狭窄段直径在0毫米至10毫米之间。切除段的平均长度为3厘米，切除的气管环数量在2至9个之间。4例患者（22.22%）出现术后并发症。所有患者在出院时以及3个月随访时均属于“良好结果”类别。
气管狭窄的手术治疗具有挑战性，需要多学科团队协作。关于手术需求和时机的全面术前准备和多学科规划、细致的术中技术以及积极的术后护理是手术成功的关键，这可为这些患者提供持久的治愈效果。
