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2012, Number 4

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Revista Cubana de Cirugía 2012; 51 (4)

Treatment of ischemic tracheal stenosis with Nd-YAG laser

García EI, Jiménez GW, Machín GVV, Madrigal G

Language: Spanish
References: 16
Page: 318-325
PDF size: 82.67 Kb.


ABSTRACT

Introduction: tracheal stenosis is a common complication secondary to intubation or to tracheostomy. There are several treatment modalities to face this problem, hence we suggested that the results of the treatment of ischemic tracheal stenosis be evaluated based on photoresection with Nd-YAG laser.
Methods: a prospective descriptive study was performed in 160 patients, who suffered ischemic tracheal stenosis and had been operated on at the Otolaryngology Service of the Medical and Surgical Research Center (CIMEQ) in the period from January 1987 to December 2010. Post-intubation tracheal stenosis was classified in five groups, according to Luis Rocabado et al.'s classification. The diagnosing method was bronchoscopy. All the patients included in the study had tracheotomy and were classified into the group I and group II. The surgical procedure performed on patients was photoresection with Nd Yag laser and placement of Montgomery's T- stent. The patients were clinically and endoscopically evaluated at discharge and afterwards at the outpatient service for one year.
Results: the highest percentage of patients was females. The age range was 30 to 49 years, with SD= 36.7 ± 5. 0 years. Ninety three (58.1%) were classified in group I whereas 67 (41.9 %) were included in group II. The most frequent cause in extended endotracheal intubation was multiple trauma. Thirteen patients suffered complications; the mortality rate was 2.5 %. The final result was evaluated as good in 94 (58.7%), satisfactory in 53 (33.2 %) and negative in 9 (5.6 %) patients.
Conclusions: The initial treatment for ischemic tracheal stenoses classified as grade I and II should be endoscopic by using Nd-YAG laser.


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