Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
University of Global Health Equity, Kigali, Rwanda.
J Cardiothorac Surg. 2024 Jan 23;19(1):21. doi: 10.1186/s13019-024-02480-w.
Nonmalignant tracheal stenosis is a potentially life threatening conditions that develops as fibrotic healing from intubation, tracheostomy, caustic injury or chronic infection processes like tuberculosis. This is a report of our experience of its management with tracheostomy, rigid bronchoscopic dilation and surgery.
Retrospective study design was used. 60 patients treated over five years period were included.
Mean age was 26.9 ± 10.0 with a range of 10-55 years. Majority (56 patients (93.3%)) had previous intubation as a cause for tracheal stenosis. Mean duration of intubation was 13.8 days (range from 2 to 27 days). All patients were evaluated with neck and chest CT (Computed Tomography) scan. Majority of the stenosis was in the upper third trachea - 81.7%. Mean internal diameter of narrowest part was 5.5 ± 2.5 mm, and mean length of stenosed segment was 16.9 ± 8 mm. Tracheal resection and end to end anastomosis (REEA) was the most common initial modality of treatment followed by bronchoscopic dilation (BD) and primary tracheostomy (PT). The narrowest internal diameter of the tracheal stenosis (TS) for each initial treatment category group was 4.4 ± 4.3 mm, 5.1 ± 1.9 mm and 6.7 ± 1.6 mm for PT, tracheal REEA and BD respectively, and the mean difference achieved statistical significance, F (10,49) = 2.25, p = 0.03. Surgery resulted in better outcome than bronchoscopic dilation (89.1% vs. 75.0%).
Nonmalignant tracheal stenosis mostly develops after previous prolonged intubation. Surgical resection and anastomosis offers the best outcome.
非恶性气管狭窄是一种潜在的危及生命的疾病，由气管插管、气管切开、腐蚀性损伤或慢性感染过程（如肺结核）引起的纤维化愈合引起。本文报告了我们采用气管切开术、硬性支气管镜扩张术和手术治疗该病的经验。
采用回顾性研究设计。纳入了过去五年中接受治疗的 60 例患者。
平均年龄为 26.9±10.0 岁，范围为 10-55 岁。大多数（56 例（93.3%））患者由于气管狭窄而存在先前的插管史。平均插管时间为 13.8 天（范围为 2-27 天）。所有患者均接受了颈部和胸部 CT（计算机断层扫描）扫描检查。大多数狭窄位于气管上段 - 81.7%。最狭窄处的内径平均为 5.5±2.5mm，狭窄段的平均长度为 16.9±8mm。气管切除和端端吻合术（REEA）是最常见的初始治疗方法，其次是支气管镜扩张术（BD）和直接气管切开术（PT）。每组初始治疗方法的气管狭窄（TS）最窄内径分别为 4.4±4.3mm、5.1±1.9mm 和 6.7±1.6mm，PT、气管 REEA 和 BD 的平均差异具有统计学意义，F（10，49）=2.25，p=0.03。手术的效果优于支气管镜扩张术（89.1% vs. 75.0%）。
非恶性气管狭窄大多在先前长时间插管后发生。手术切除和吻合术可获得最佳疗效。
