Stenoses of Trachea after Cannulation
Authors:
J. Lukáš 1; J. Paska 1; J. Votruba 2; S. Černohorský 3
Authors‘ workplace:
Oddělení ORL Nemocnice Na Homolce, Praha
; primář MUDr. J. Paska
Oddělení vnitřních nemocí Nemocnice Na Homolce, Praha
1; primář doc. MUDr. J. Kábrt, CSc.
Oddělení chirurgie Nemocnice Na Homolce, Praha
2; primář MUDr. P. Beňo
3
Published in:
Otorinolaryngol Foniatr, 56, 2007, No. 3, pp. 133-136.
Category:
Original Article
Overview
Stenoses of trachea after cannulation represent severe, life-threatening complications of tracheal intubation and trachemostomy. In connection with extending intensive and resuscitation care there incidence is on the increase. In the years 2004-2006, 15 patients with post-cannulation stenosis, 11 of them men and 4 women at the average age of 59 years, were diagnosed and treated at the Na Homolce Hospital in Prague. The patients were generally critically ill with application of artificial ventilation and trachemostomy. Stenoses were diagnoses after the removal od cannula with the average time lapse of 141 days in s.c. volitional interval. The stenoses were localized in the subglottic space six times and nine times in the area of trachemostomy or distal end of cannula. The dilatation was performed in 7 patients, dilatation with the administration of stent in three patients and the stenosis segment was resected and anastomosis end to end was created in 6 patients. Re-stenosis developed in one patient to be subsequently treated by dilatation and introduction of a stent. Repeated tracheostomy and revision of tracheostomy for bleeding complications proved to be the most frequent causes of stenoses. Patients who were subjected to long-term intubation (>48 hours) and those after tracheostomy should be observed for long period of time and controlled by tracheobronchoscopy.
Key words:
stenosis of trachea, intubation, tracheostomy, dilatation, resection.
Sources
1. Fiala, P., Černohorský, S., Čermák, J., Moučková, M., Pátek, J., Petřík, F.: Faktory ovlivňující vývoj postkanylačních stenóz průdušnice. Otorinolaryng. a Foniat. /Prague/, roč.50, 2001, č. 4, s. 240-245.
2. Golger, A., Rice, L. L., Jackson, B. S., Young, J. E. M.: Trachea necrosis after thyroidectomy. Canadian Journal of Surgery, roč. 45, 2002, č. 2, s. 463-464.
3. Haruštiak, S., Majer, I., Benej, R., Pereszlenyi, A. jr., Bohucky, S., Jurakova, O., Dzuberova, I., Kajanovicova, V.: Tracheostenosis and treatment. Bratisl Lek Listy, roč. 100, 1999, 6, s. 291-295.
4. Janoušek, P., Kabelka, Z., Marková, M. : Zúžení hrtanu a průdušnice u dětí. Otorunolaryng. a Foniat. /Prague/, 55, 2006, č. 3, s. 161–167.
5. Koitshev, A.,Graumueller, S., Zenner, H. P., Dommerich, S., Simon, C.: Tracheal stenosis and obliteration above the tracheostoma after percutaneous dilational tracheostomy. Crit-Care-Med, roč. 31, 2003, č. 5, s. 1574-1576.
6. Koudela, J., Marel, M.: Postkanylační stenózy průdušnice - možný důsledek zajištění dýchacích cest v intenzivní péči. Anesteziologie a neodkladná péče, roč. 12, 2001, č. 3, s. 117-119.
7. Machač, J., Šlapák, I., Strnadová, M., Sedláková,Y.: Dilatační laryngotracheoplastika-řešení subglotické stenózy. Otorinolaryng.a Foniat. /Prague/, roč. 50, 2001 č. 4, s. 237-240.
8. Mandour, M., Remacle, M., van de Heyning, P., Elwany, S., Tantawy, A., Gaafar A.: Chronic subglottic and trachea stenosis: endoscopic management vs. surgical reconstruction. Eur Arch Otorhinolaryngol, 2003 č. 206, s. 374-380.
9. Marel, M., Pekárek, Z., Fiala, L., Špásová, I., Pafko, P., Schutzner, P., Pospíšil, R., David, I.: Benigní stenózy velkých dýchacích cest. Čas. Lék. Čes., roč. 141, 2002, č. 19, s. 610-614.
10. Pafko, P., Haruštiak, S. et al.: Praktická chirurgie trachey. 1.vyd., Praha, Galén, 2001, 111 s.
11. Raghuraman, G., Rajan, S., Marzouk, J. K., Mulhi, D., Smith, F. G.: Is tracheal stenosis caused by percutaneous tracheostomy different from that by surgical tracheostomy? Chest, roč. 127, 2005, č. 3, s. 879-885.
12. Sarper, A., Aytem, A., Eser, I., Ozbudak, O., Demircan, A.: Tracheal stenosis after tracheostomy or intubation. Tex Heart Indy J., roč.32, 2005, s. 154-158.
13. Skácel, J., Pospíšil, I.: Problematika dlouhodobé intubace a tracheostomie v resuscitační péči. Anesteziologie a neodkladná péče, roč. 4, 1993, č. 1 s. 15-18.
14. Štefl, M., Válek, V.: Současné možnosti diagnostiky a léčby tracheální stenózy. Prakt.Lék., roč. 85, 2005, č. 8, s. 441-444.
15. Wynn, R., Har-El. G., Lim, J. W.: Tracheal resection with end to end anastomis for benign tracheal stenosis. Ann Otol Rhinol Laryngol, roč. 113, 2004, s. 613-617.
16. Zietek, E., Matyja,G., Kawczynski, M.: Stenosis of the larynx and trachea: diagnostics and treatment. Otolaryngologia Polska, roč. LV, 2001, č. 5, s. 515-520.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2007 Issue 3
Most read in this issue
- Clinical Problems of Hypopharygeal Carcinomas
- Stenoses of Trachea after Cannulation
- Profiloplasty of Rhinoplasty
- Using Cartilage Grafts by Retraktion Pockets by Children