Endoscopic management of idiopathic tracheal stenosis

Ann Thorac Surg. 2011 Jul;92(1):297-301. doi: 10.1016/j.athoracsur.2011.03.129.

Abstract

Background: Idiopathic tracheal stenosis (ITS) is a rare condition representing a difficult therapeutic challenge. Endoscopic management is a therapeutic option but long-term results are not established. The aim of this retrospective multicenter study was to analyze long-term outcome after endoscopic management of ITS.

Methods: Nine institutions involved in interventional bronchoscopy were contacted and asked to identify ITS endoscopically treated. A standard form was used to report the main characteristics and long-term outcome after endoscopic management.

Results: Twenty-three patients, 96% women, aged 45±16 years, were endoscopically treated for ITS. Time between first symptoms and diagnosis was 19±18 months. Bronchoscopy showed a weblike (61%) or complex (39%) stenosis, located in the upper part of the trachea, mainly in the cricoid area. Endoscopic treatment included mechanical dilation only (52%) or associated with laser or electrocoagulation (30%) and stent placement (18%). All procedures were efficient. The follow-up after endoscopic management was 41±34 months. The ITS recurrence occurred in 30% at 6 months, 59% at 2 years, and 87% at 5 years, with a delay of 14±16 months. The treatment of recurrence (n=13) included endoscopic management in 12 cases.

Conclusions: Endoscopic management of ITS provides a safe and efficient therapeutic option but late recurrences are frequent and require long-term follow-up.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Biopsy, Needle
  • Bronchoscopy / methods
  • Catheterization / methods*
  • Electrocoagulation / methods
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy / methods
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Assessment
  • Stents
  • Time Factors
  • Tomography, X-Ray Computed / methods
  • Tracheal Stenosis / diagnosis*
  • Tracheal Stenosis / etiology
  • Tracheal Stenosis / surgery*
  • Treatment Outcome