Infectious Diseases

A case of successful circular resection of a trachea due to cicatricial stenosis in a HIV-infected patient

The authors describe a clinical case of surgical treatment of stenosing disease of a trachea in a 31-year-old male patient with HIV infection and post-intubation cicatricial tracheal stenosis requiring urgent intervention – circulatory resection of the trachea. Surgery was performed due to life-threatening indications. The post-operative period took a more severe course than in HIV- negative patients and included severe inflammatory processes in the tracheobronchial tree, respiratory disorders and slower healing of tracheal anastomosis. Multiple control endoscopic examinations and interventions were required aimed at removal of granulations in the trachea, which resulted eventually in recovery of the patient. This clinical case shows that active surgical tactics in a HIV-positive patient with tracheal stenosis is justified. HIV infection should not serve as a sufficient reason for denial of surgery in patients with surgical pathologies. Surgery should be performed in full volume and presuppose radical d-bridement of a scar-changed segment of the trachea with restoration of patency of the airways. It would be appropriate to operate on such patients in specialized multi-profile surgical clinics having years-long experience of such surgery.