MULTIDISCIPLINARY MANAGEMENT OF COMPLEX TRACHEAL STENOSIS: INTEGRATION BETWEEN THORACIC SURGERY AND INTERVENTIONAL

Resumen

Acquired tracheal stenosis represents a significant complication, primarily associated with prolonged orotracheal intubation, mechanical ventilation, and tracheostomy. Between 2021 and 2026, recent literature highlighted substantial advances in the understanding of risk factors, early diagnosis, and therapeutic strategies. Early recognition in critically ill patients, particularly those subjected to prolonged ventilation, and the implementation of preventive protocols in intensive care settings, have been emphasized. Therapeutically, endoscopic approaches, including dilation and stent placement, have demonstrated efficacy in selected cases, especially for short and non-complex stenoses. However, tracheal resection with reconstruction remains the gold standard for extensive or refractory lesions. Comparative analyses indicate that optimal outcomes are achieved through careful patient selection and integration of specialized teams. The multidisciplinary model, involving interventional pulmonology, thoracic surgery, anesthesiology, and intensive care, is central to optimizing results and reducing complications. Structured longitudinal follow-up is essential for monitoring recurrence and ensuring long-term functional stability. Future perspectives emphasize increased incorporation of technologies such as computational modeling and customized devices, consolidating precision medicine in airway management. Contemporary management of tracheal stenosis should therefore be integrated, individualized, and evidence-based, prioritizing patient safety and functional outcomes.