The etiological factors of recurrence after tracheal resection and reconstruction in post-intubation stenosis.
We assessed several factors which might be responsible for the recurrence of post-intubation airway stenosis in a large group of patients who underwent resection and reconstruction surgery by one surgical team. Four hundred and ninety-four patients underwent reconstruction of post-intubation airway stenosis during 1995-2006. The case group comprised patients who had developed recurrence, while controls had no recurrence. The diagnosis of the recurrence was made based on the presence of clinical signs or symptoms and bronchoscopic evaluation. The following variables were compared in both groups: age, sex, duration of intubation, reason for intubation, period of time between intubation and surgery, history of previous tracheotomy, previous therapeutic interventions, subglottic involvement, length of resection, presence of unusual tension at the site of anastomosis and anastomotic infection. Fifty-two patients (10.5%) developed recurrence. Lengthy resection, presence of tension at the site of anastomosis, anastomotic infection and subglottic involvement were significantly higher in the case group. Logistic regression model showed that the three main predictors are anastomotic infection (OR=3.44), subglottic involvement (OR=2.43), and presence of tension (OR=1.97), respectively. It is concluded that the surgeon can play an important role in avoiding recurrence by decreasing tension, preventing infection, and preserving subglottic structure.
Abbasidezfouli
Azizollah
A
Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Akbarian
Ehsan
E
Shadmehr
Mohammad Behgam
MB
Arab
Mehrdad
M
Javaherzadeh
Mojtaba
M
Pejhan
Saviz
S
Abbasi-Dezfouli
Golbahar
G
Farzanegan
Roya
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D005931:Glottis / Q000601:surgery; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011312:Pressure; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D014135:Tracheal Stenosis / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult