Long term outcomes of patients with benign tracheal stenosis after multidisciplinary management

Treatment for benign tracheal stenosis remains controversial. Endoscopic management is often considered conflicting to surgery. We aimed to evaluate the long term results of multidisciplinary management in our patients cohort during the last 5 years. 24 patients (17 males), aged 48,5±20,2 (mean ± st.dev) with symptomatic tracheal stenosis were referred to our center. Patients were stratified in 5 groups as A: short/web stenoses (n=5), B: long/complex stenoses (n=11), C: Post-surgery relapse (n=4), D: Complications/Relapse after stent placement (n=2) and E: External compression (n=2). Therapeutic decisions were made on the principle that operable complex stenoses should be operated whereas short stenoses should first undergo interventional endoscopy reserving surgery for recurrence. If surgery was declined, patients were interventionally treated. 7 patients (groups A:1, B:5, C:1), underwent surgical tracheal resection and anastomosis. 3 patients (group A) underwent simple bronchoscopic resection and dilatation and never relapsed since. 15 patients (Groups A:1, B:7, C:3, D:2, E:2) received stent placement. 1 of them (group B) finally underwent surgery due to relapse. All patients were successfully treated and reported well after 34,9±23,8 months of follow up. No deaths occurred. Major complications included 1 case of bilateral pneumothorax during bronchoscopic intervention and a severe relapse of stenosis over a tracheal stent, both successfully undertaken by surgeons. Interventional bronchoscopy and tracheal surgery are both valuable options. Multidisciplinary counseling on each case using a simple therapeutic algorithm, may lead to successful long term results in practically all patients.