2008, Number 3
Orotracheal intubation duration and post-intubation tracheal stenosis length, a non-established relation
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ABSTRACTIntroduction: Tracheal stenosis deserves special attention due to its particular characteristics. Full knowledge of this disease is fundamental for the thoracic surgeon in order to confront this pathology within an integral and rational approach, leading to the achievement of a definitive and permanent resolution. Segmental cylindrical resection with end-to-end anastomosis is the cornerstone in the surgical treatment.
Material and methods: This was an observational, retrospective, longitudinal and comparative study on patients with diagnosis of post-intubation tracheal stenosis, and under treatment in the National Institute of Respiratory Diseases (Mexico). The aim of the study was to identify a potential relationship between the length of intubation and the number of affected tracheal rings.
Results: Seventy nine patients were included, 30.4% of them presenting some co-morbidity, mainly diabetes mellitus (13.9%). Trauma was the most frequent cause of orotracheal intubation (51.9%). The region predominantly affected was the sublglottis (94.9%), and the mean stenosis percentage was 73.8%. An average of 3.44 tracheal rings were affected, and 71% cases showed 60-80% stenosis. A statistically significant relationship (p ‹ 0.001) was found between the number of days with the tracheal tube and the number of involved rings. Morbidity rate was 30.4% and mortality rate reached 5.06%.
Discussion: The contribution of this paper is that a clear statistically significant association was found between the length of intubation and the number of stenotic tracheal rings, and therefore with the amount of resected rings. The greater the time spent with the tracheal tube, the greater the severity and complexity of stenosis, as well as the greater the tracheal resections and the increased difficulty for surgical resolution. Most patients evolved satisfactorily, with a complication rate similar to those already reported, though with a slightly greater mortality.
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