Evaluation of cases with postintubation tracheal stenosis undergoing tracheal resection and reconstruction in KTU Thoracic Surgery clinic

OBJECTIVE: Postintubation tracheal stenosis (PETS) is the most common cause of tracheal stenosis. The vast majority of patients present with stridor and dyspnea. PETS is a major cause of morbidity and mortality if left untreated. Rigid bronchoscopy is the best diagnostic method and is very useful in evaluating the localization and borders of the lesion. In addition, 3D CT of the neck and thorax taken is important in showing the relationship, size and location of the stenosis with the surrounding tissues. These evaluations determine patients' suitability for non-operative treatment options (t-tube, stent, etc.) or surgery. Surgical treatment is applied as the gold standard in the appropriate patient. In this study, we tried to determine the treatment options, follow-up and factors that may cause complications in patients who underwent tracheal resection for PETS in our center. MATERIALS AND METHODS: Our study was designed as retrospective and observational. The data of 44 patients with postintubation tracheal stenosis who underwent tracheal resection and reconstruction at Karadeniz Technical University Farabi Hospital Thoracic Surgery Clinic between January 2014 and December 2021 were analyzed. Inclusion criteria were all ages (13-68 for current patients), cases with postintubation tracheal stenosis who underwent tracheal resection and reconstruction, anamnesis, radiological imaging and laboratory results in the hospital database. In this analysis, variables were determined as age, gender, reason for intubation, location of stenosis, length of resection, and complications. RESULTS: Trauma was the most common cause of intubation in the patients included in the study. All patients had stridor. 26 (59.1%) of the patients had at least one additional disease. Stenosis was located in the upper half of the trachea in 33 (75%) and in the lower half of the trachea in 11 (25%) of the patients. The length of the tracheal segment removed during surgery was less than 3 cm in 26 (59.1%) of the patients, and over 3 cm in 18 (40.9%) patients. Complications were seen in 16 (36%) patients, 5 female and 11 male, in total. Post-operative hospital stay of the patients who underwent tracheal resection and reconstruction varied between 4-16 days. CONCLUSION: In this thesis study, cases with postintubation tracheal stenosis who underwent end-to-end anastomosis after tracheal resection were evaluated. Although a significant p value was not reached in patients with complications, preoperative tracheostomy history, presence of additional disease, and resections of the upper half of the trachea were seen as important predisposing factors for complications. Thanks to the retention sutures applied in our clinic, the chin-neck suture was not placed on the patient.. This situation provided patient comfort in the post-op period, and the incidence of anastomosis-related complications decreased. Keywords: postintubation tracheal stenosis, retention suture, bronchoscop