Abstract
Introduction: Tracheal stenosis after intubation or tracheostomy is the most common cause of benign narrowing, occuring in 6%-21% of cases. The diagnosis may be delayed, resulting in prolonged dependency on mechanical ventilation and tracheostomy or the emergence of symptomatic tracheal obstruction following ICU discharge. Treatment of stenosis can be done surgically or with endoscopic techniques. The use of cryosurgery through the flexible bronchoscope, with cryoadhesion and cryotherapy techniques, is a safe method for the removal of granulation or fibrous tissue and restoration of the lumen.
Methods: Between 2010-2017, 16 patients (mean age 53 years) with benign tracheal stenoses were treated. Cryotherapy was applied through the flexible bronchoscope under local anesthesia and mild sedation. Granulation tissue removal was accelerated by detachment of fragments by cryoadhesion. Web-like stenoses with more than 60% obstruction were initially treated with electrocautery knife incisions followed by cryotherapy. The patients were followed for one year after the end of their treatment.
Results: 9 patients had granulomas, 6 patients had a web-like stenosis and one patient had a complex lesion. The stenoses were a result of intubation and / or tracheostomy during hospitalization in the ICU. 5 patients had restenosis after surgical treatment of complex stenoses. A total of 37 sessions were required (mean 2.3). 14 patients (87%) were treated successfully without complications and without relapse after 1 year, while 2 required eventually surgical treatment.
Conclusions: Cryotherapy through flexible bronchoscopy is safe and effective in simple benign tracheal stenoses following intubation and tracheostomy.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA4160.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018