Long-term outcomes of surgical management in post-intubation tracheal stenosis: a retrospective analysis of tracheal resection and reconstruction.

Abstract

Post-intubation tracheal stenosis (PITS) is a serious complication of prolonged intubation, often requiring surgical intervention. This study aims to present the long-term outcomes of patients with PITS who underwent tracheal resection and reconstruction, as well as to discuss the efficacy of these surgical methods in comparison to stenting. This retrospective study included patients treated for PITS at our center between October 2005 and October 2022. Patients were divided into two groups: those who underwent tracheal resection and reconstruction (n = 29) and those treated with stenting (n = 47). The clinical characteristics, surgical techniques, complications, and long-term outcomes were recorded and analyzed. The mean age of the patients was 41.3 years, with 40.0% aged between 40 and 60 years. The mean intubation duration was 16.8 days. In the resection group, 22 of 29 patients (75.8%) showed no recurrence or complications during long-term follow-up. The overall success rate for surgical treatment was 93.1%, with a mortality rate of 6.8%. In the stenting group, successful stent removal was achieved in 9 of 47 cases, with a mean stent removal time of 26 months. Granulation tissue formation and restenosis were more frequently observed in stented patients compared to those who underwent surgery. Tracheal resection and end-to-end anastomosis remain the gold standard treatment for PITS, with a lower recurrence rate and fewer long-term complications compared to stenting. However, stenting may be a viable option for patients who are not suitable candidates for surgery. Careful preoperative evaluation and long-term follow-up are essential to optimize patient outcomes.