The Treatment of Post-Intubation Tracheal Stenosis

Objective: Post-intubation tracheal stenosis (PETS) remains a threat despite the advances in intensive care conditions and improvements in intubation tubes. The best treatment of PETS is surgery. The purpose of this study was to present our experience on patients with PETS and discuss the issue in the light of literature.

Materials and Methods: Between January 2000 and January 2007, 9 patients who had been applied tracheal resection and reconstruction for PETS were retrospectively evaluated. All of the patients were male with a mean age of 33.8 years (range: 11 yrs–52 yrs.). The average intubation duration was 7.8 days (3-15 d). Before the surgery, dilatation with rigid bronchoscopy with an average number of 2.7 (1-7 times) was performed on all the patients and a stent was inserted in one patient with rigid bronchoscopy. Duration from intubation to surgery was 4.8 months (1-12 months). Collar incision was performed on all the patients. As the cartilago cricoidea had been affected in 3 patients, tirotracheal anastomosis in the anterior region and cricotracheal anastomosis in the posterior region were constituted. In the other patients, “end-to-end” tracheal anastomosis was performed after the resection.

Results: Postoperatively, only one patient developed wound infection. Dissemination of infection to the anastomosis line was prevented through antibiotherapy and debridement. No perioperative mortality was observed. The mean postoperative hospitalization time of the patients was 10.6 days (range:9-15 days). In the postoperative follow-up, no recurrences were observed.

Conclusion: PETS treatment requires a multidisciplinary approach. If initial treatment is inadequate, and there is no medical counterindication, the best treatment of PETS is tracheal resection after rigid bronchoscopy.