Morphological changes in cicatrical stenosis of the trachea. The effect of long-term endoprosthesis on the epithelium
Аннотация
Elimination of persistent and extensive defects of the anterior wall of the trachea is an urgent problem and continues to be the subject of research and discussion of thoracic surgeons, plastic surgeons and otolaryngologists. Despite the large number of studies devoted to this problem, to the present time, the morphogenesis of scar stenosis of the trachea has not been studied enough. The Department of surgery of lungs and mediastinum SI "RSSPMCS named after akad. V. Vakhidov" has experience in treating 212 patients with CST from 2008 to 2019. Only in 42 cases it was possible to perform radical surgery-circular resection of the trachea. Some patients were cured by endobronchial interventions. 120 patients underwent multi-stage reconstructive interventions on the trachea, as they had severe comorbidities, neurological deficits, and other aggravating factors, which did not allow them to be cured simultaneously. In 28 cases, morphological studies of the wall of the altered trachea were performed. Morphological studies have shown that in tracheal stenosis there is a reduction of the epithelial lining of the mucous membrane with a significant growth of coarse-fibered connective tissue. Primary in the development of tracheal stenosis is damage to the epithelial lining. Dilation with a T-shaped prosthesis for 5-6 months helps to restore the multilayer epithelium of the mucous membrane, longer stenting leads to the appearance of highly specialized ciliated and goblet-shaped cells. In more distant terms of stenting (15 months) there is a marked tendency of appearance of ciliated and goblet-shaped cells in the surface layers of multi-row epithelium.