title: Long-term results of laryngotracheal resection for benign stenosis from a series of 109 consecutive patients.
abstract: OBJECTIVE
  Long-term results of patients undergoing laryngotracheal resection for benign stenosis are reported. This is the largest series ever published.
  
  
  METHODS
  Between 1991 and March 2015, 109 consecutive patients (64 males, 45 females; mean age 39 ± 10.9 years) underwent laryngotracheal resection for subglottic postintubation (93) or idiopathic (16) stenosis. Preoperative procedures included tracheostomy in 35 patients, laser in 17 and laser plus stenting in 18. The upper limit of the stenosis ranged between actual involvement of the vocal cords and 1.5 cm from the glottis. Airway resection length ranged between 1.5 and 6 cm (mean 3.4 ± 0.8 cm) and it was over 4.5 cm in 14 patients. Laryngotracheal release was performed in 9 patients (suprahyoid in 7, pericardial in 1 and suprahyoid + pericardial in 1).
  
  
  RESULTS
  There was no perioperative mortality. Ninety-nine patients (90.8%) had excellent or good early results. Ten patients (9.2%) experienced complications including restenosis in 8, dehiscence in 1 and glottic oedema requiring tracheostomy in 1. Restenosis was treated in all 8 patients with endoscopic procedures (5 laser, 2 laser + stent, 1 mechanical dilatation). The patient with anastomotic dehiscence required temporary tracheostomy closed after 1 year with no sequelae. One patient presenting postoperative glottic oedema underwent permanent tracheostomy. Minor complications occurred in 4 patients (3 wound infections, 1 atrial fibrillation). Definitive excellent or good results were achieved in 94.5% of patients. Twenty-eight post-coma patients with neuropsychiatric disorders showed no increased complication and failure rate.
  
  
  CONCLUSIONS
  Laryngotracheal resection is the definitive curative treatment for subglottic stenosis allowing very high success rate at long term. Early complications can be managed by endoscopic procedures achieving excellent and stable results over time.
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy adandrilli@hotmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Andrilli
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maurizi
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Andreetti
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ciccone
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Poggi
authors.affiliation: Department of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy Lorillard Spencer Cenci Foundation, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.affiliation: Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University, Rome, Italy Lorillard Spencer Cenci Foundation, Rome, Italy.
authors.forename: Erino Angelo
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000328:Adult; D005260:Female; D005931:Glottis / Q000601:surgery; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D007830:Larynx / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D015607:Stents; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome; D014827:Vocal Cords / Q000601:surgery
keywords: Laryngotracheal resection; Subglottic stenosis