Published on June 16, 2009, doi:10.1510/icvts.2009.202978
Interactive CardioVascular and Thoracic Surgery 2009;9:446.
The etiological factors of recurrence after tracheal resection and reconstruction in post-intubation stenosis
Azizollah Abbasidezfouli 1,
Ehsan Akbarian 1*,
Mohammad Behgam Shadmehr 1,
Mehrdad Arab 1,
Mojtaba Javaherzadeh 1,
Saviz Pejhan 1,
Golbahar Abbasi-Dezfouli 1,
Roya Farzanegan 1
1 Masih Daneshvari Hospital, NRITLD, Tehran, Iran
* To whom correspondence should be addressed. E-mail: eakbarian{at}gmail.com.
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Abstract |
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We assessed several factors which might be responsible for the recurrence of post-intubation airway stenosis in a large group of patients who underwent resection and reconstruction surgery by one surgical team. 494 patients underwent reconstruction of post-intubation airway stenosis during 1995-2006. The case group comprised patients who had developed recurrence, while controls had no recurrence. The diagnosis of the recurrence was made based on the presence of clinical signs or symptoms and bronchoscopic evaluation. The following variables were compared in both groups: age, sex, duration of intubation, reason for intubation, period of time between intubation and surgery, history of previous tracheotomy, previous therapeutic interventions, subglottic involvement, length of resection, presence of unusual tension at the site of anastomosis and anastomotic infection. 52 patients (10.5%) developed recurrence. Lengthy resection, presence of tension at the site of anastomosis, anastomotic infection and subglottic involvement were significantly higher in the case group. Logistic regression model showed that three main predictors are anastomotic infection (OR=3.44), subglottic involvement (OR=2.43), and presence of tension (OR=1.97), respectively. It is concluded that the surgeon can play an important role in avoiding recurrence by decreasing tension, preventing infection, and preserving subglottic structure. Keywords: Tracheal stenosis; Anastomosis; Restenosis
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