Benign Stenoses of the Large Respiratory Pathways

Overview

Background.
Benign stenoses of main respiratory pathways develop usually in patients after intubation ortracheostomy. Incidence of such states is not known, they are frequently diagnosed too late, and there are differentviews of their treatment. In order to contribute to the improvement of our knowledge of this serious impairment wefollowed prospectively all patients with this diagnose at our department since March 1998.Methods andResults. The group of 31 patientswith benign stenoses of non-tumorous origin diagnosed and treatedat the TRN of the Teaching Hospital Motol in years 1998 to 2000 consisted of 24 males and 7 females, age medianwas 52 years. Stenosis was caused in 27 patients by intubation, in 4 patients by some other causes. At admission weperformed in 30 patients electrocauterization and dilatation of stenosis, one patient was immediately indicated forsurgery. Beside two cases we always achieved sufficient patency of stenosis and weighted indication to surgery. Wesent for surgery 15 patients, 10 patients were permanently healed using methods of interventional bronchoscopy,including introduction of stent in 6 cases. From the remaining 6 patients, two of them are planned for resection ofstenosis, four are inoperable from various reasons, and two died of causes not related to stenosis.Conclusions. Based on our experience we recommend as an optimal management of such patients is the dilatationor removal of stenosis and then always to consider resection of trachea. In inoperable cases methods of interventionalbronchoscopy should be used.Authors recommend sending all patients intubated longer than 2 days for bronchoscopicexamination in interval of 2 months.

Key words:
cicatriceous stenoses of respiratory pathways, interventional bronchoscopy, trachea.