Ahmed Mostafa
Ain Shams University, Egypt
Title: Review of sixty tracheal resections and anastomosis. A seven year experience of a tertiary Egyptian referral institute
Biography
Biography: Ahmed Mostafa
Abstract
Aim & Introduction: Tracheal stenosis is one of the major complications following prolonged endotracheal intubation. Tracheal resection and anastomosis has proved to be the best solution for this serious problem. This study aims to review the experience of our institute in 7 years with patients presenting with post-intubation tracheal stenosis.
Methods: A retrospective study was performed in the period of January 2009 to January 2016. This study involved patients who were presented to the Ain Shams University Hospital with post-intubational tracheal stenosis, and who underwent tracheal resection and anastomosis as a primary treatment.
Results: We operated upon 60 patients, excluding glottic stenosis pathology, and patients with major co-morbidities with tracheostomies or stents as definitive treatment. Patients included 42 males (70%), 18 females (30%) and the mean age was 28.35 (ranging from 2 to 72 years). During the treatment, it was found that 45 patients (70%) had previous endoscopic dilataions, 38 patients (63.3%) had tracheostomies, 19 patients (31.6%) had a history of tracheal stenting whereas, 17 patients (28.3%) had cricotracheal resections (CTR) for subglottic stenosis. Cervicotomy was sufficient in 41 patients (68.3%), but additional manubriotomy was needed in 15 patients (25%), while full sternotomy was done in only 4 patients (6.6%). All patients were given a chance for immediate postoperative extubation and the anastomotic success rate was (96.6%) and hospital mortality was (1.6%).
Conclusion: Tracheal resection and anastomosis proves to be a safe and satisfactory option for post-intubational tracheal stenosis. This intervention must be applied widely in developmental countries where there is frequent rush for tracheostomies, and abuse of tracheal stenting and dilatation. Hence, quality of life improves dramatically following an effective surgery.