Tracheal Surgery - a 10-year Center Experience

Abstract

Background: Tracheal surgery is a specialized field in which many disciplines work jointly due to the variety of indications and the extended topography. The main indications for surgery include inflammatory (generally post-intubation), congenital or post-traumatic stenoses, benign or malignant neoplasms and tracheal lacerations, whether iatrogenic or traumatic. The purpose of this study is to review the management of one institution's approach to a wide variety of tracheal lesions over the last 10 years.
Methods: We retrospectively analyzed data of all subjects submitted to tracheal surgery in our center, between January 1, 2014 and December 31, 2023. The preoperative and postoperative data were retrospectively evaluated through the consultation of the clinical files and the computer registry system.
Results: We included 24 patients, mean age of 53 years (min 19; max 87), 54% being female. The most frequent indication for surgery was post-intubation tracheal stenosis (16, 67%) followed by tracheal laceration (6, 25%) and pleomorphic adenoma of the trachea (2, 8%). The mean operative time was 148 minutes (min: 80; max. 205). The mean tracheal length resected was 2,14 cm (min: 1; max: 3,2). Postoperative complications included: vocal cord paralysis (2, 8%), surgical wound site infection (2, 8%), anastomotic dehiscence (1, 4%) and mediastinitis (1, 4%). Re-stenosis occurred in 1 patient who was treated with prosthesis placement via bronchoscopy and 1 patient required definitive tracheostomy due to vocal cord paresis. Median chin stitch duration and median length of stay was 10 and 15 days, respectively. In-hospital mortality was 8% (2 cases). Overall mortality during mean follow-up time (51 months) was 8% (2 cases).
Conclusions: Tracheal surgery seems a valid and safe technique in selected patients and can be performed safely with low morbidity and mortality, according to our center results.