REOPERATIVE TRACHEAL RESECTION AND RECONSTRUCTION FOR UNSUCCESSFUL REPAIR OF POSTINTUBATION STENOSIS

Objective: Our objective was to analyze characteristics and results of redo tracheal resection and reconstruction. Methods: Seventy-five pat ients were operated on between 1966 and 1997 after unsuccessful initia l repairs for postintubation tracheal stenosis. Results: Sixteen of th ese patients came from a group of 32 patients with unsuccessful repair among the 450 primary resections and reconstructions performed at our institution. Fifty-nine patients were referred to us after unsuccessf ul initial repair elsewhere. Initial management was a T-tube or trache otomy in 39 patients. The length of repeat resection ranged from 1.0 c m to 5.5 cm (mean 3.5 cm). A laryngeal release was used in 19 patients (25%) to reduce anastomotic tension. Complications occurred in 29 pat ients (39%) and Here most frequent in the group requiring laryngeal re lease (12/19, 63.2%). Overall outcome was good in 59 patients (78.6%) and satisfactory in 10 (13.3%). The repair was unsuccessful in four pa tients (5.3%), and two patients died (2.6%). Conclusions: Despite diff iculties encountered in reoperative surgery after failed tracheal reco nstruction for postintubation stenosis, successful outcome may be achi eved in a large number of cases.