title: Long-term results after 110 tracheal resections.
abstract: OBJECTIVE
  Among the many therapeutic options for treating tracheal stenosis (e.g. bouginage, laser resection and stenting), segmental resection and reconstruction with end-to-end anastomosis is the method of choice. We verified this in an analysis of clinical material.
  
  
  METHODS
  We retrospectively evaluated 110 tracheal sleeve resections performed between 1985 and 2001. Data before and after resection were analyzed, and the patients were interviewed.
  
  
  RESULTS
  The aetiology of stenosis was mainly postintubation injury (n = 92) (83.6%), followed by goiter with malacia (n = 8) (7.3%) and tumor (n = 6) (5.5%). There were a few other causes (n = 3) (2.7%). 48 patients (43.6%) had undergone prior conservative or surgical treatment other than sleeve resection. A cervical approach was used in 93 (84.6%), a cervicomediastinal in 15 (13.6%), and a transthoracic in two. Healing of anastomosis was uncomplicated in 101 patients (91.8%). Major and minor complications occurred in 29 patients (26.4); there were 4 dehiscences (3.6%), 3 restenoses (2.7%), 2 suture line granulations (1.8%) and 4 vocal cord dysfunctions (3.6%). The 30-day mortality rate was 0.9%. 77 patients were interviewed after surgery (median 80.1 months); 93.5% (n = 72) were satisfied with the surgical treatment.
  
  
  CONCLUSIONS
  Resection and reconstruction offer the best treatment for tracheal stenosis. Lethal complications were due to severe comorbidity. Many patients today still undergo unsuccessful conservative treatment before being referred to surgery.
authors.affiliation: Department of Thoracic Surgery, Schillerhoehe Hospital, Centre for Pneumology and Thoracic Surgery, Gerlingen, Germany. friedel@klinik-schillerhoehe.de
authors.forename: Godehard
authors.initials: G
authors.lastname: Friedel
authors.forename: Thomas
authors.initials: T
authors.lastname: Kyriss
authors.forename: Andrea
authors.initials: A
authors.lastname: Leitenberger
authors.forename: Heikki
authors.initials: H
authors.lastname: Toomes
references.citation: Ann Thorac Surg. 1986 Sep;42(3):287-98
references.pmid: 3753077
references.citation: J Thorac Cardiovasc Surg. 1997 Dec;114(6):934-8; discussion 938-9
references.pmid: 9434688
references.citation: Ann Otol Rhinol Laryngol. 1986 Nov-Dec;95(6 Pt 1):582-5
references.pmid: 3789593
references.citation: Br J Surg. 1950 Oct;38(150):200-5
references.pmid: 14791963
references.citation: Thorac Cardiovasc Surg. 1985 Feb;33(1):2-7
references.pmid: 2579455
references.citation: Int Surg. 1982 Jul-Sep;67(3):235-9
references.pmid: 6761293
references.citation: Ann Surg. 1969 Mar;169(3):334-48
references.pmid: 5266019
references.citation: J Thorac Cardiovasc Surg. 1995 Mar;109(3):486-92; discussion 492-3
references.pmid: 7877309
references.citation: Chirurg. 2001 Oct;72(10):1119-29
references.pmid: 11715614
references.citation: Arch Otolaryngol. 1974 Apr;99(4):255-60
references.pmid: 4594223
references.citation: Eur J Cardiothorac Surg. 1993;7(6):300-5
references.pmid: 8347355
references.citation: Ann Thorac Surg. 1995 Aug;60(2):250-9; discussion 259-60
references.pmid: 7646083
references.citation: J Thorac Cardiovasc Surg. 1975 Nov;70(5):806-16
references.pmid: 1186272
references.citation: Eur Respir J. 1999 Apr;13(4):888-93
references.pmid: 10362058
references.citation: Laryngoscope. 1973 Aug;83(8):1204-10
references.pmid: 4758123
references.citation: Chirurg. 1991 Jul;62(7):547-51
references.pmid: 1935381
references.citation: Ann Thorac Surg. 1994 May;57(5):1120-4; discussion 1124-5
references.pmid: 8179373
references.citation: J Thorac Cardiovasc Surg. 2001 Jan;121(1):68-76
references.pmid: 11135161
references.citation: Intensive Care Med. 1998 Jul;24(7):685-90
references.pmid: 9722038
references.citation: Can J Anaesth. 1997 Dec;44(12):1282-5
references.pmid: 9429047
references.citation: J Thorac Cardiovasc Surg. 1979 Dec;78(6):860-75
references.pmid: 502569
references.citation: Eur J Cardiothorac Surg. 1990;4(5):265-8; discussion 268-9
references.pmid: 2357392