Abstract
Objective. Main issues of treatment of patients with cicatricial stenosis of trachea (CST) are to increase its efficacy and safety, as well as to determine indications and contraindications for surgery on the trachea in patients with extended lesions of respiratory tract, with stenoses involving subvocal cords part of larynx and well as multifocal narrowing of the trachea which could improve treatment results and quality of life of patients. Methods. 98 patients with CST were surgically treated. Localization of CST: in the upper third of the trachea in 42 (45.6%) patients, intrathoracic part in 14 (15.2%), laringotraheal lesion in 22 (23.9%), larynx and intrathoracic part in 6 (6.5%), cervical and thoracic trachea (7.6%) in 7, obliteration of the trachea over tracheostomy cannula in 6, postoperative anastomotic stenoses of the trachea (5 patients came from other centers). length of CST varied from 0.3 to 7 cm. Results. Resection of the trachea was performed in 24 patients. In case of contraindications, 28 patients underwent reconstructive surgery with T-shaped stent. After removing of T-shaped stent, plasty of anterior tracheal wall and of soft tissues of the neck defects was performed using local tissues and grafts. Conclusions. Patients with CST should undergo multimodal approach depending on degree and localization of narrowing, length and levels of restriction, taking into account severity of associated pathologies using complex of endosurgical, resection and reconstructive treatments. When an extended CST involvement in the process is more than 30–50% of the trachea up to 5-6 cm, it's possibly to perform tracheal resection provided that mobilization of necessary levels is sufficient.