KNOWLEDGE OF ETIOLOGY OF TRACHEAL STENOSIS AND ESTIMATE OUTCOME OF TRACHEAL RESECTION AND END-TO-END ANASTOMOSIS FOR TRACHEAL STENOSIS

Objective: To know the etiology (causes) of tracheal stenosis and estimate outcome of tracheal resection and end-to-end anastomosis for tracheal stenosis. Design: Descriptive prospective case series. Place and Duration: Department of thoracic surgery, Services Hospital, Lahore from May 2014 to March 2019. Patient and Methods: Twenty-two patients were involved in the study that go through the process of dividing trachea into part combining them again by the same surgical team. Etiology (causes) was find out on the basis of available history pre-operative findings. The process is done by using VICRYL 3/0(medicine name) outcome of surgical technique estimated top expiratory-flow-rate and flexible bronchoscopy. Results: Twenty-two patients were managed over a period of five years, of which 17 (77.3%) were male and 5(22.7%) females. Mean patient age was 27.31 +/- 9.61years. Seven (31.8%) patients had New York Heart Association grade (NYHA)-III and 15(68.2%) had NYHA grade-IV dyspnea. Seventeen (77.3%) had stridor. All patients were already being managed by pulmonologists, ENT specialists or intensivists. Twelve (54.5%) had Grade-V stenosis (91-100% luminal obstruction) and 9 (40.9%) had grade-IV stenosis (76-90% obstruction). Six (27.3%) patients had subglottic stenosis, 13 (59.1%) had cervical tracheal stenosis and 3(13.6%) had mediastinal tracheal stenosis. Six (27.3%) patients had partial cricoid resection followed by thyrotracheal anastomosis, 13(59.1%) patients underwent cervical tracheal anastomosis and 3 (13.6%) patients required mediastinal tracheal anastomosis. Patients were followed up post-operatively for the development of immediate and delayed complications. The follow up was carried out for a minimum period of 6 months to a maximum period of 2 years. Postoperative complications included neck pain, lung collapse, and superficial skin infection. Conclusion: The process of division and then recombining the parts of trachea is safe, reliable and permanent procedure for the treatment of tracheal stenosis.