Treatment of Benign Stenoses of the Large Airways at the Faculty Hospital
Praha-Motol During 1998–2003
Marel M.1, Pekárek Z.2, Skácel Z.2, Špásová I.2, Pafko P.3, Schützner J.3, Betka J.4, Pospíšil R.5
H. klinika TRN, 1. LF UK a FVN Praha, přednosta prof. MUDr. J. Homolka, DrS. 2Pneumologická klinika 2. LF UK a FN Motol, Praha, přednosta doc. MUDr. J. Musil 3III. chirurgická klinika 1. LF UK, Praha, přednosta prof. MUDr. P. Pafko, DrS. 4ORL klinika 1. LF UK a FN Motol, Praha, přednosta prof. MUDr. J. Betka, DrS. 5Chirurgická klinika 2. LF UK a FN Motol Praha, přednosta doc. MUDr. J. Hoch, CS. |
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Summary:
The authors present diagnostic and therapeutical results in the group of 80 patients with benign stenoses of
large airways, whowere hospitalized at theTRNward (Department ofTBand respiratory disorders) of the Faculty
hospitalMotol in Prague between the years 1998–2003. 62 patients sufferred fromstenoses in cosequence of their
tracheal intubation or tracheostomy. In 18 cases the stenoses resulted from other disorders or pathological
condidtions (Wegener‘s granulomatosis, status post lung transplantation, etc.) 38 patients were sent for surgery.
Up until the date of the assessment (September 2003), 8 of them had had a relaps of the condiditon. 6 operated
subjects had their restenosis corected using bronchological methods, 2 subjects had to undergo reoperation, which
is 5.2% of the total number of the operated subjects. The remaining 42 patients were treated using the
interventional bronchological methods (electrocauther, laser, stents) which proved curative in 35 patients, i.e
44% of the whole group. In 7 inoperable patients the above methods failed, 6 of them having a permanent tracheostomy and one female-patient exited 2 days after an incomplete recanalization. In the subgroup of 18
patients with other than postintubation stenoses, stent operations were the most frequent (12times), 4 patients
were cured using other methods of interventional bronchology, and resection of the stenosis was indicated in two
cases. Up until the date of the assessment, 65 subjects had survived and 15 exited. 5 of them died 3–14 months
(median of 4months) following the surgical procedure of other disorders than of the respiratory airways stenoses.
10 unoperated patients, with a single exception, also died due to other causes than the tracheobroncheal lesions
(the survival rate median was 9 months). Following the initial freeing of the airways, the authors call for
considering a surgical therapeutical option in each case. Provided the surgical approach was contraindicated, the
interventional bronchological methods would replace it appropriately.
Key words:
benign postintubation stenosis – large airways – resection of the trachea – interventional
bronchology
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