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. 2023 Mar 9:10:1129803.
doi: 10.3389/fsurg.2023.1129803. eCollection 2023.

Management of COVID-19-related post-intubation tracheal stenosis

Serena Conforti  1 , Gloria Licchetta  1 , Marco Reda  1 , Arash Astaneh  1 , Luca Pogliani  1 , Stefano Fieschi  1 , Alessandro Rinaldo  1 , Massimo Torre  1
Affiliations

Management of COVID-19-related post-intubation tracheal stenosis

Serena Conforti et al. Front Surg. .

Abstract

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has affected Italy since the beginning of 2020. Endotracheal intubation, prolonged mechanical ventilation, and tracheostomy are frequently required in patients with severe COVID-19. Tracheal stenosis is a potentially severe condition that can occur as a complication after intubation. The aim of this study was to evaluate the utility and safety of endoscopic and surgical techniques in the treatment of tracheal stenosis related to COVID-19.

Materials and methods: Between June 2020 and May 2022, consecutive patients with tracheal stenosis who were admitted to our surgical department were considered eligible for participation in the study.

Results: A total of 13 patients were included in the study. They consisted of nine women (69%) and four men (31%) with a median age of 57.2 years. We included seven patients with post-tracheostomy tracheal stenosis. Bronchoscopy was performed to identify the type, location, and severity of the stenosis. All patients underwent bronchoscopic dilation and surveillance bronchoscopy at 7 and 30 days after the procedure. We repeated endoscopic treatment in eight patients. Three patients underwent tracheal resection anastomosis. Final follow-up bronchoscopy demonstrated no residual stenosis.

Conclusions: The incidence of and risk factors associated with tracheal stenosis in critically ill patients with COVID-19 are currently unknown. Our experience confirms the efficacy and safety of endoscopic management followed by surgical procedures in cases of relapsed tracheal stenosis.

Keywords: COVID-19; balloon dilatation; endoscopic treatment; tracheal stenosis; tracheal surgery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Tracheal stenosis (Myer–Cotton grade II); bronchoscopic examination. (B) Endoscopic result after balloon dilation. (C) Surgical resection of the trachea. (D) Suture of the anterior tracheal wall.
See this image and copyright information in PMC

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