Long-term results of laryngotracheal resection for benign stenosis.
OBJECTIVE
We report the long-term results of our 16-year experience with laryngotracheal resection for benign stenosis.


METHODS
Between 1991 and 2006, 35 consecutive patients (19 males, 16 females) underwent laryngotracheal resection for subglottic postintubation (32) or idiopathic (3) stenosis. Mean age was 43 years (range 14-71). At the time of surgery 13 patients presented with tracheostomy and 7 with a Dumon stent. The upper limit of the stenosis was from 0.6 to 1.5 cm below the vocal cords. The length of airway resection ranged between 1.5 and 6 cm. Suprahyoid release was performed in two patients and pericardial release in one. Nine patients had psychiatric and/or neurological post-coma disorders. Mean follow-up is over 5 years (61 months; range 3-194).


RESULTS
There was no perioperative mortality. Thirty patients (85.7%) had excellent or good anatomic and functional results. Four patients (11.4%) presented restenosis at a distance of 25-110 days from the operation. Restenosis was successfully treated by endoscopic procedures in all four patients. One patient (2.9%) presented anastomotic dehiscence that required temporary tracheostomy closed after 1 year with no sequelae. Three patients (8.4%) had wound infection. Long-term follow-up was uneventful also in patients who had early complications.


CONCLUSIONS
Long-term follow-up confirms that laryngotracheal resection is the definitive curative treatment for benign subglottic stenosis. Surgical complications can be successfully managed by non-operative procedures. Despite the occurrence of early complications, excellent and stable results can still be obtained at long term.
D'Andrilli
Antonio
A
Department of Thoracic Surgery, University of Rome La Sapienza, Sant'Andrea Hospital, Rome, Italy. adandrilli@hotmail.com
Ciccone
Anna Maria
AM
Venuta
Federico
F
Ibrahim
Mohsen
M
Andreetti
Claudio
C
Massullo
Domenico
D
Formisano
Rita
R
Rendina
Erino A
EA
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation / Q000009:adverse effects; D007825:Laryngectomy; D007829:Laryngostenosis / Q000150:complications / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D055815:Young Adult