Conforti Serena, Licchetta Gloria, Reda Marco, Astaneh Arash, Pogliani Luca, Fieschi Stefano, Rinaldo Alessandro, Torre Massimo
Department of Thoracic Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
Front Surg. 2023 Mar 9;10:1129803. doi: 10.3389/fsurg.2023.1129803. eCollection 2023.
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has affected Italy since the beginning of 2020. Endotracheal intubation, prolonged mechanical ventilation, and tracheostomy are frequently required in patients with severe COVID-19. Tracheal stenosis is a potentially severe condition that can occur as a complication after intubation. The aim of this study was to evaluate the utility and safety of endoscopic and surgical techniques in the treatment of tracheal stenosis related to COVID-19.
Between June 2020 and May 2022, consecutive patients with tracheal stenosis who were admitted to our surgical department were considered eligible for participation in the study.
A total of 13 patients were included in the study. They consisted of nine women (69%) and four men (31%) with a median age of 57.2 years. We included seven patients with post-tracheostomy tracheal stenosis. Bronchoscopy was performed to identify the type, location, and severity of the stenosis. All patients underwent bronchoscopic dilation and surveillance bronchoscopy at 7 and 30 days after the procedure. We repeated endoscopic treatment in eight patients. Three patients underwent tracheal resection anastomosis. Final follow-up bronchoscopy demonstrated no residual stenosis.
The incidence of and risk factors associated with tracheal stenosis in critically ill patients with COVID-19 are currently unknown. Our experience confirms the efficacy and safety of endoscopic management followed by surgical procedures in cases of relapsed tracheal stenosis.
自2020年初以来，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行已影响到意大利。重症新型冠状病毒肺炎（COVID-19）患者经常需要进行气管插管、长时间机械通气和气管切开术。气管狭窄是一种潜在的严重疾病，可作为插管后的并发症出现。本研究的目的是评估内镜和手术技术在治疗与COVID-19相关的气管狭窄中的实用性和安全性。
在2020年6月至2022年5月期间，入住我们外科的连续气管狭窄患者被认为符合参与本研究的条件。
本研究共纳入13例患者。其中包括9名女性（69%）和4名男性（31%），中位年龄为57.2岁。我们纳入了7例气管切开术后气管狭窄患者。进行支气管镜检查以确定狭窄的类型、位置和严重程度。所有患者在术后7天和30天接受支气管镜扩张和监测支气管镜检查。我们对8例患者重复进行了内镜治疗。3例患者接受了气管切除吻合术。最终随访支气管镜检查显示无残留狭窄。
目前，重症COVID-19患者气管狭窄的发生率及相关危险因素尚不清楚。我们的经验证实了在内镜治疗后进行手术治疗复发性气管狭窄的有效性和安全性。
