Possibilities of plastic and reconstructive surgical procedures on the trachea in treatment of cicatricial stenoses
Abstract
Security resection and reconstructive plastic surgery on the trachea remains an important issue. Postoperative complications of circular tracheal resection constitute 6,2-28%, and postoperative mortality according to some can reach 10%. Another challenge for the treatment of patients category are patients with multifocal lesions tracheal stenosis at two or more levels of intact and tracheal wall there between.Materials and methods: We used a differentiated approach based on an integrated using of endoscopic methods and plastic and reconstructive interventions in 92 patients. The length of the stenotic site of patients ranged from 0.3 to 7 cm. Results and discussion. In critical stenosis with diameter up to 5 mm by the first step we used an endoluminal treament. In the absence of contraindications of the comorbidities we carried out circular resection of the trachea. The length of the trachea resected fragments ranged from 2.0 to 5.5 cm. We used continuous seam to create the membranous wall of anastomosis. On the sidewalls created fixing interrupted sutures. In the presence of contraindications of the comorbidities patients underwent plastic surgery with formation of lumen of the trachea at the T- stent. Conclusions: Resection of the trachea in its cicatricial stenoses is a highly effective and radical treatment, allowing to remove the narrowed segment of the trachea and to form the tracheal anastomosis within healthy cartilage rings. Application of plastic-reconstructive surgery allows to generate lumen of the trachea with contraindications to resection.