Tracheal stenosis. One region experience

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<b>Objective:</b> Tracheal stenosis (TS) after a long-time artificial lung ventilation remains to be a problem in our region. The aim of the study was find ways to reveal, prevent and treat TS in these patients. <b>Metuods:</b> Constant supervision namely CT-scan and endoscopy have been used in 126 patients concerned (I group). The data of 150 patients with evident symptoms of TS including emergency cases were also reviewed (II group). The method of treatment was chosen in accordance with clinical variant of the stenosis. In initial stages of TS endoscopic sanation, granulation debridement, and cryotherapy was undertaken. Bougienage was performed in 124 patients. T-tube placement and subsequent reconstructive operations were necessary in 104 cases after the bougienage. In 66 patients (4 from I group and 62 from II group) circular tracheal resections were performed including 16 patients underwent bougienage. <b>Results:</b> In the I group TS was found in 24 patients (19.0%), and in 17 of them who had initial alteration endoscopic treatment was succsessful. Bougienage followed by T-tube placement and subsequent reconstructive operations was successful in 93 patients, and 11 ones are still under treatment. No complications followed these procedures. Circular resection of the trachea resulted in recovery in 61 cases. Restenosis after resection developed in 2 cases required repeated stenting. Erosion hemorrage occured in 2 patients. Overall complication and lethality rates were 9.2% and 3.1% respectively. <b>Conclusions:</b> Permanent observation of patients after prolonged tracheostomy is necessary to detect TS in early stages. Endoscopic treatment undertaken in proper time results in recovery and avoids urgent situations and heavy surgical interventions.