Source: Annual Congress 2009 - How to deal with tracheal stenosis
Disease area: Thoracic oncology

Abstract

Ojectives: To evaluate the indications and outcome of different treatment techniques in tracheal stenosis.
Methods: A five years retrospective study of all the cases of tracheal stenosis treated in our hospital.
Results: 287 patients with tracheal stenosis were reffered between 2004 - 2008. There were 175 males (61%) and 112 females, median age 48±10.4 years (range 12-84).
The etiology of the tracheal stenosis was neoplasic in 182 (67.3%)cases - 154 pulmonary carcinoma, 7 tyroid cancer, 11 esophageal cancer, 2 lymphoma, 3 atypical carcinoid and 5 metastatic lesions. Among the 105 cases of non-malignant stenosis, 81% complicated prolonged intubation or tracheostomy.
212 patients were treated with different therapeutic bronchoscopy methods. 104 stents were inserted: 45 Polyflex, 23 Montgomery, 13 Dumon, 12 metallic and 11 Y Freitag stents. Several endoscopic techniques were combined: Nd:YAG laser resection in 57 patients, electroresection in 75 patients and 45 mechanical dezobstructions/dilatations. All the interventional bronchoscopy procedures were performed under general anesthesia with jet ventilation. In most cases(65%), the indication was palliative, for malignant tracheal stenosis. Among these, 13 patients had former pneumonectomy for pulmonary carcinoma.
Tracheal resection was performed in 75 patients, most of them(85.5%) with non-malignant stenosis. 14 cases required endoscopic treatment before surgery and 5 cases with restenosis after tracheal resection needed further bronchoscopic treatment.Major complications occured in less than 1% of cases.
Conclusions: An increasing number of complex tracheal stenosis often requires a multidisciplinary management in order to improve the clinical condition and the patients quality of life.

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P. Grigore, E. Crisan, R. Ulmeanu, M. Alexe, R. Stoica, G. Cadar, I. Ion, I. Cordos, N. Galie, C. Saon, C. Paleru (Bucharest, Romania). Multidisciplinary management of tracheal stenosis. Eur Respir J 2009; 34: Suppl. 53, 4235

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