Argon Plasma Coagulation in Treatment of Post Intubation Tracheal Stenosis

Abstract INTRODUCTION: Acquired tracheal stenosis can be created by various malignant or benign causes. The most common cause of acquired non-malignant tracheal stenosis is endotracheal intubation, even for a short period. Argon plasma coagulation is a non-contact method of thermal hemostasis. Argon plasma coagulation can be used easily and fast and has low depth of penetration. METHODS: This study is single blinded. Subjects are patients with tracheal stenosis after endotracheal intubation who were selected by non-probability sampling and were studied from March ۲۰۰۷ to November ۲۰۰۹ in bronchoscopy and laser center of Masih Daneshvari Hospital, Tehran. First, for each patient, a diagnostic flexible bronchoscopy was performed to identify the type, location, and severity of the stenosis. Then, under general anesthesia, patients underwent rigid bronchoscopy. Then, with Argon plasma coagulation device (ERBE VIO ۲۰۰D) the stenosis was removed as possible. After two weeks, a new PFT (pulmonary function test) was done for checking the obstructive signs.RESULTS: Of these ۳۴ patients, ۲۴ were asymptomatic for more than ۱ year and responded to treatment(۷۰/۶%), ۵ were asymptomatic for more than ۱۰ months and less than ۱۲ months (۱۴/۷%) and ۵ did not have asymptomatic periods more than ۱۰ months, and did not respond to treatment. In PFT follow-ups, FEV۱ in all patients who were asymptomatic for more than ۱۰ months had a significant progress; therefore, in ۲۷ out of ۲۹ patients at the end of the study, FEV۱ was more than ۹۰% and ۲ patients had FEV۱ of ۷۰-۹۰%.CONCLUSION: In fact, although the surgical treatment remains the main treatment of tracheal stenosis after intubation (PITS), if this method is not possible for any reason, APC is very useful as a safe and effective method. Keywords: Argon Plasma Coagulation Bronchoscopy Post Intubation Tracheal Stenosis