P008

M. Rusakova (Prof), V. Parshina (Prof), M. Simonova*a (Dr)

a Sechenov University Hospital, Moscow, RUSSIAN FEDERATION

* simonova-mary@yandex.ru

Background: benign tracheal stenosis is a rare but extremely serious condition that significantly impairs patient’s quality of life and can potentionally be fatal. The problem of postintubation and posttracheostomy tracheal stenoses remains relevant due to the spread of COVID-19.

Methods: tracheal resection is the main treatment method of benign tracheal stenosis. In most cases, patient is prepared for this surgical procedure by interventional pulmonology methods. Some patients cannot be treated surgically immediately due to the severity of their general condition or if the stenosis is long or complex. In this case we perform stenting or T-tube tracheal reconstruction. After that tracheal resection is perfomed, if possible.

We perform dilatation of stenosis using rigid bronchoscopy or balloon dilatation gradually increasing the diameter of bronchoscope or dilatator by 1 mm under total intravenous anesthesia. Dumon silicone stents and self-made endotracheal tube stents are used for long-term dilatation of stenosis.

Results: 1279 patients who underwent 3705 procedures from 2001 to 2021 were recruited. 2059 endoscopic (854 stenosis dilatations, 454 stentings, 362 stent removals, 349 granulation resections, 40 stent repositions), and 1646 surgical (436 tracheal resections, 1210 T-tube tracheal reconstructions) interventions were performed. 291 (22.76%) patients underwent surgical treatment. 196 (15.32%) patients were treated by means of endoscopic interventions. 792 (61.92%) patients underwent combined endoscopic and surgical treatment. 921 (72.01%) patients successfully completed treatment. 9 (0.7%) patients remain long-term tracheotomized (tracheostomy tube or T-tube). 126 (9.85%) patients undergo treatment at present. Hospital mortality was 0.94 % of the total number of patients.

Conclusion: The classical combination of interventional pulmonology and surgery for the treatment of benign tracheal stenosis demonstrates minimal mortality rate and high efficiency. The successful use of these methods allows to treat patients not only with complex stenoses but also those with extremely poor status, especially after prolonged ventilation for COVID-19.

Disclosure of funding source(s): none