Endoscopic Management of Idiopathic Tracheal Stenosis

Background. Idiopathic tracheal stenosis (ITS) is a rare condition representing a difficult therapeutic challenge. Endoscopic management is a therapeutic option but long-term results are not established. The aim of this retrospective multicenter study was to analyze long-term outcome after endoscopic management of ITS. Methods. Nine institutions involved in interventional bronchoscopy were contacted and asked to identify ITS endoscopically treated. A standard form was used to report the main characteristics and long-term outcome after endoscopic management. Results. Twenty-three patients, 96% women, aged 45 +/- 16 years, were endoscopically treated for ITS. Time between first symptoms and diagnosis was 19 +/- 18 months. Bronchoscopy showed a weblike (61%) or complex (39%) stenosis, located in the upper part of the trachea, mainly in the cricoid area. Endoscopic treatment included mechanical dilation only (52%) or associated with laser or electrocoagulation (30%) and stent placement (18%). All procedures were efficient. The follow-up after endoscopic management was 41 +/- 34 months. The ITS recurrence occurred in 30% at 6 months, 59% at 2 years, and 87% at 5 years, with a delay of 14 +/- 16 months. The treatment of recurrence (n = 13) included endoscopic management in 12 cases. Conclusions. Endoscopic management of ITS provides a safe and efficient therapeutic option but late recurrences are frequent and require long-term follow-up. (Ann Thorac Surg 2011;92:297-302) (C) 2011 by The Society of Thoracic Surgeons