Plastic of trachea with the formation of a lumen on the T-shaped endoprosthesis in the treatment of patients with scar stenosis and severe comorbidity

Abstract

We analysed the results of treatment of 154 patients with stenosis of the trachea and larynx in the period from 2008 to 2018. In 85 patients, reconstructive operations were performed, consisting in the plastic of the trachea with the dissection of the stenosis zone, the excision of scar tissues and the formation of a lumen on the T-shaped endoprosthesis. Of these, in 6 patients T-stent was installed at another medical hospital, and they developed restenosis after decanulation, as a result, they were performed re-stenting. In 4 patients, T-stenting was performed for restenosis of the anastomosis after circular resection of trachea. The period of dilation on a T-shaped endoprosthesis varied from 6 to 14 months.

When decompensated and critical stenosis of the lumen with diameter less than 5 mm with the threat of asphyxia, the first step is performing endoscopic destruction with subsequent bougienage of the narrowing zone. In patients with extended and multifocal cicatrical stenosis of the trachea and unextended cicatrical stenosis with severe concomitant neurological disorders was performed plastic reconstruction of the trachea with the formation of a stable lumen of the trachea on T-shaped implant.

Conclusions: in patients with multifocal and multilevel tracheal stenosis in the presence of neurological deficit and severe concomitant pathology, when performing circular tracheal resection is impossible, reconstruction on T-shaped endoprosthesis is the “gold standard”.