Endoscopic treatment of benign cicatricial tracheal stenoses

Background. Benign tracheal stenosis is relatively rare but remains a significant chronic disease due to its drastic symptoms including dyspnoea and inspiratory stridor, and consequent negative effect on quality of life. Traditionally, the surgical approach by resection of the stenotic tracheal segment has been the therapy of choice. However, endoscopic techniques have arisen and may offer a safe and less invasive alternative. The purpose of the study was analysis of results of surgical treatment for tracheal cicatricial stenosis, taking into account the use of minimally invasive endoscopic methods. Materials and methods. The study comprised 105 patients with tracheal cicatricial stenosis who were admitted to the clinic of the V.T. Zaytsev Institute of Gene­ral and Urgent Surgery of the National Academy of Medical Sciences of Ukraine. The study was conducted in 2018–2024. The patients were divided into two groups: І group — 75 participants who were initially candidates for endoscopic treatment of tracheal cicatricial stenosis, and surgical intervention was considered only in case of failure, their treatment was conducted until 2018; and group ІІ — 30 people with contraindications to circular tracheal resection or such operation was considered to be inappropriate, their endoscopic treatment was conducted since 2018. Results. Modern endoscopic treatment for tracheal cicatricial stenosis with length of < 1.0 cm using precision electrodissection allows to carry out recanalization of the stenosis without complications. With the length of tracheal cicatricial stenosis of more than 50 % of trachea length, the method of choice remains prolonged dilatation with a Montgomery T-tube. Conclusions. Minimally invasive endoscopic interventions should be considered as a method of choice to achieve tracheal lumen size sufficient for breathing in patients who have contraindications to radical surgery.