Topical Issues of Surgical Treatment of Cicatricial Tracheal Stenosis

Abstract

Advances in surgery make it possible to successfully treat seriously ill patients who are on prolonged artificial lung ventilation. As a result of a combination of ischemia, trauma and infection of the tracheal mucosa due to chronic inflammation, the normal structures of its wall are replaced by fibrous tissue, which is manifested by narrowing of the tracheal lumen with the development of progressive suffocation. Despite the studies conducted, the mechanism and timing of the formation of a chronic inflammatory reaction and a fibrous process in the affected area and peripheral bronchopulmonary structures in various variants of post-intubation tracheal complications are not sufficiently disclosed. One of the most important areas in tracheal surgery is ensuring the safety of operations in order to reduce the number of postoperative complications and mortality. This applies both to simultaneous radical operations and stage-by-stage interventions, as well as to new intra-light technologies. The advantage of cicatricial tracheal stenosis is the possibility of preserving the pathologically altered tracheal wall for the formation of the respiratory tract, unlike oncological practice. Further development of tracheal surgery directly depends on the introduction of preventive measures and analysis of adverse factors associated with an increased risk of complications. An integrated approach to the prevention, treatment and rehabilitation of patients with cicatricial tracheal stenosis allows us to develop personalized tactics aimed at improving the effectiveness of treatment and achieving full rehabilitation of each patient. We believe that the research conducted in this field of science is promising.