2009, Number 4
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ABSTRACTObjective: To present the result of a series of cases of tracheal stenosis surgically treated by means of tracheoplasty during five years at a public hospital in Mexico City. Place: Third-level attention hospital. Design: Retrospective, observational and transversal study. Statistical analysis: Percentages as a measure of qualitative variables. Material and methods: It was analyzed every operated case during the period going from January 1st 2003 to December 31st 2007 with a diagnosis of acquired or congenital tracheal and operated through tracheoplasty. The diagnosis was obtained by respiratory endoscopy and complementary studies that included bronchography, axial computed tomography (CAT scan) and/or magnetic resonance imaging (MRI) from neck/thorax, as well as pulmonary function tests. There were three groups according to the stenosis magnitude: Type I (soft), Type II (mild) and Type III (severe or serious) with a specific treatment for each kind of stenosis. The evaluated variables were age, gender, etiology, localization, type of stenosis, clinical groups, associated abnormalities, complications, type of medical treatment –endoscopic or surgical–used surgical technique or endoscopy, follow-up period, and final result. Results: From a total of 50 patients with a diagnosis of tracheal stenosis, 25 (50%) of them were prospects for the surgical treatment. The average age was of 35.6 years (ranging from 15 to 64); there were 26 (52%) men and 24 (48%) women. The principal etiology was endotracheal intubation in 42 patients (84%), followed by tracheal granuloma (8%), obliterating stenosing tracheitis (4%), and bronchogenic endotracheal cancer secondary to extrinsic obstruction due to thyroid cancer in one (2%) patient, respectively. The most frequent indication for endotracheal intubation in these cases was the cranioencephalic traumatism diagnosis (43%), and the average intubation time was of 17.5 days (ranging from four to 60 days). The stenosis was just placed in the trachea and the extension of it was of 2 to 7 trachea rings. The surgical treatment consisted of a termino-terminal tracheoplasty. The complications were mainly re-stenosis in four cases (8%) and infection at the surgical hurt in two cases (4%). There was no peril-operative mortality. Conclusion: The surgical treatment is an excellent therapeutic choice, with a high success index, low mortality and, generally, without associated mortality. Re-stenosis presents a greater frequency when it is practiced through an extensive tracheal resection.
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