Technique of laryngotracheal resection in subglottic stenosis

Journal of Thoracic Disease
E Stoelben, A Aleksanyan

Abstract

Cervical stenosis of the trachea caused by tracheotomy, tumor or induced by inflammatory disease can be treated by resection and anastomosis with good early and long-term results. Involvement of the ring cartilage makes the procedure technical demanding and increases the risk of morbidity. We describe our technique of laryngotracheal resection and reconstruction and compare the perioperative results with standard trachea resection. Between January 2005 and September 2018, we performed 92 standard cervical tracheal resections and 50 laryngotracheal resection including 6 procedures with widening of the ring cartilage. The resections were realized by direct anastomosis using dorsal flaps and/or interposition of rib cartilage in the posterior part of the ring cartilage. In one case intraoperative tracheotomy and intralaryngeal stenting was used. Patient records have been analyzed for perioperative data retrospectively. The main cause for stenosis or defect of the trachea and operation is preceding tracheotomy. Idiopathic stenosis, tumors and subglottic stenosis in Wegener disease are less common. Healing of the anastomosis was not disturbed in any patient. In two patients, bronchoscopic resection of granulation tissue was necessary...Continue Reading

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