[Surgical and combined correction of tracheal and laryngotracheal cicatricial stenosis and restenosis].

Aim: To improve treatment of patients with cicatricial tracheal stenosis using different methods of recanalization and circular resection.
Material and Methods: Analysis involved 57 patients with cicatricial tracheal stenosis including 2 post-traumatic cases, 27 post-intubation cases, 25 cases after tracheostomy and 3 restenoses after previous circular resection. There were 5 cases of tracheal stenosis combined with tracheoesophageal fistula, 1 patient with chest nodular goiter, 8 cases of unclosed tracheostomy and 3 patients with long-existing laryngotracheal fissure. There were 25 women and 32 men aged 15-65 years. Stenosis length ranged from 3.0 to 4.5 cm in 66.6% of patients. There were 13 (22.8%) patients with subcompensated stenosis (d=0.5-0.7 cm) and 44 (77.2%) cases of decompensated stenosis (d<0.5 cm) combined with suppurative tracheobronchitis that required endosurgical recanalization with stenting or balloon dilatation. 45 patients underwent upper tracheal third resection, 9 - middle third resection, 3 - upper third and cricoid cartilage resection. Length of excised segment was 2.5-9.5 cm. Simultaneous suturing of esophageal anterior wall defect was performed in 5 cases.
Results: Complete recovery of tracheal lumen was achieved in 54 patients (93%). Restenosis occurred in 4 (7%) cases (3 of them underwent repeated resection with good results and 1 - stenting).
Conclusion: Circular resection is optimal treatment of cicatricial tracheal stenosis. Endosurgical recanalization is preparatory method prior to radical surgery.