1. Eur Arch Otorhinolaryngol. 2013 Sep;270(10):2709-17. doi:
10.1007/s00405-013-2367-6. Epub 2013 Feb 9.

Circumferential tracheal resection with primary anastomosis for post-intubation
tracheal stenosis: study of 24 cases.

Negm H(1), Mosleh M, Fathy H.

Author information: 
(1)Depatment of Otolaryngology Head and Neck Surgery, Kasr ElAini University
Hospital, Cairo University, Cairo, Egypt. drnegment@hotmail.com

The objective of this study is to evaluate the results of circumferential
tracheal and cricotracheal resection with primary anastomosis for the treatment
of post-intubation tracheal and cricotracheal stenosis. This is a retrospective
analytical study. A total number of 24 patients were included in this study. The 
relevant preoperative, operative and postoperative records were collected and
analyzed. Twenty patients were finally symptom-free reflecting an anastomosis
success rate of 83.3 %. Variable grades of anastomotic restenosis occurred in 11 
(45.8 %) patients, three patients were symptom-free and eight had airway
obstructive symptoms. Four out of the eight patients with symptomatic restenosis 
were symptom-free with endoscopic dilatation while the remaining four patients
required a permanent airway appliance (T-tube, tracheostomy) for the relief of
airway obstruction and this group was considered as anastomotic failure. Cricoid 
involvement, associated cricoid resection and the type of anastomosis were the
variables that had statistical impact on the occurrence of restenosis (P = 0.017,
0.017, 0.05; respectively). Tracheal resection with primary anastomosis is a safe
effective treatment method for post-intubation tracheal stenosis in carefully
selected patients. Restenosis does not always mean failure of the procedure since
it may be successfully managed with endoscopic dilatation.

PMID: 23397061  [PubMed - indexed for MEDLINE]