Utility of Rigid Bronchoscopic Dilatation and Mitomycin C Application in the Management of Postintubation Tracheal Stenosis Case Series and Systematic Review of Literature

Background: Postintubation tracheal stenosis (PITS) is a common problem encountered by interventional pulmonologists. The aim of this study was to evaluate the utility of mitomycin C (MMC) as an adjunctive treatment to rigid bronchoscopic dilatation in patients with PITS. Methods: Prospective analysis of data from the interventional pulmonology unit of a large tertiary care teaching center in North India. Patients with a diagnosis of PITS undergoing rigid bronchoscopic dilatation and MMC (0.4 mg/mL) application were included. The primary outcome was the occurrence of restenosis. Results: Seven patients underwent rigid bronchoscopic dilatation, followed by the application of MMC at 4 quadrants of the stenosis. Controlled radial expansion balloon bronchoplasty was also performed, if necessary, in addition to mechanical dilatation using the barrel of the rigid bronchoscope. Restenosis occurred in all 7 patients (100%) and the mean duration to the detection of restenosis was 27 days. The restenosis was symptomatic in 6 out of 7 (85.7%) patients. Conclusions: Rigid bronchoscopic dilatation and a single application of MMC is not an effective treatment in the management of PITS.