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Vol. 26. Issue 1.
Pages 17-22 (January - February 1990)
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Vol. 26. Issue 1.
Pages 17-22 (January - February 1990)
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Estenosis traqueales no tumorales: consideraciones terapéuticas en 102 pacientes
Nontumoral tracheal stenoses: therapeutic considerations in 102 patients
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J.M. Borro, V. Tarazona, F. París, J. Seguí, G. Galán, J.M. Caffarena Calvar
Servicio de Cirugía Torácica. Hospital La Fe. Valencia
M. Casillas*
* Servicio de Cirugía Torácica. Hospital La Paz. Madrid
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Entre 1973 y 1988 se trataron 102 pacientes afectos de estenosis traqueal no tumoral. La reanimación respiratoria fue la causa de la estenosis en 95 enfermos. Setenta y tres pacientes se intervinieron quirúrgicamente, con un global de 80 operaciones; 29 se sometieron a terapéutica endoscópica exclusiva. En 26 casos la decisión quirúrgica se adoptó tras el fallo de la dilatación-coagulación. De los 73 enfermos operados, 49 presentaban estenosis traqueal pura y 24 laringotraqueal. En las estenosis traqueales simples se realizó resección-anastomosis y en las formas subglóticas intervenciones tipo Rethi, Pearson y Couraud.

Con respecto a los resultados quirúrgicos, hay que destacar la diferencia existente entre los obtenidos en los cinco primeros años (1973-78) y los de los diez últimos. Igualmente, se ha de señalar que en las estenosis laringo-traqueales las dificultades técnicas fueron mayores y la morbilidad postoperatoria fue más importante, presentando un número de reintervenciones superior al de las estenosis traqueales puras. La mortalidad global de la serie fue de 7/73, aunque en los últimos 10 años descendió a 1/42 (2%). Los resultados definitivos se consideraron como buenos en 60 pacientes y aceptables en cuatro. Dos enfermos precisaron traqueostomía definitiva.

From 1973 to 1988, 102 patients with nontumoral tracheal stenosis were treated. Respiratory reanimation was the cause of the stenosis in 95 patients. Seventy-three patients were operated on, with overall 80 operations; 29 patients had exclusive endoscopic treatment. In 26 cases operation was decided when dilatation-coagulation failed. 49 of the 73 operated patients had pure tracheal and 24 had laryngo-tracheal stenoses. In simple tracheal stenoses resection-anastomosis was carried out, while Rethi, Pearson and Couraud operations were performed for subglottic forms.

Regarding the results of surgery, there was a remarkable difference between those from the first five (1973-78) and the last ten years. It is also noteworthy that technical problems were more serious in laryngótracheal stenoses, with a higher postoperative morbidity and higher reoperation rate than in pure tracheal stenoses. The overall mortality rate was 7/73, although in the last ten years it became 1/42 (2%. The definitive results were considered good in 60 patients and fair in four. Two patients required definitive tracheostomy.

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Copyright © 1990. Sociedad Española de Neumología y Cirugía Torácica
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