Management of benign tracheal stenosis: rigid bronchoscopy versus serial cannulas-a retrospective cohort study from a tertiary center.

BACKGROUND: Benign tracheal stenosis is increasingly recognized and diagnosed; however, its optimal management is not standardized, and no international guidelines are currently available. This study focuses on comparing the outcomes in terms of reintervention and complications between two different techniques for central airway dilation. METHODS: A retrospective comparative cohort study was conducted including patients diagnosed with benign tracheal stenosis at a tertiary-care center between January 2024 and January 2025. Patients were treated by two departments-thoracic surgery and interventional bronchoscopy-using serial Rusch cannula (RC) dilatation or rigid bronchoscopy (RB), respectively. RESULTS: A total of 47 patients were included: 27 in the RC group and 20 in the RB group. Most stenoses were Cotton-Myer grade III in both groups. A history of orotracheal intubation (OTI) was present in 37 patients (24 RC vs. 13 RB). Median time to recurrence after the first dilatation was 16 days in RC and 23 days in RB (P=0.12). The RC group required fewer reinterventions (median 2 vs. 4; P<0.01), but had a higher complication rate (37% vs. 10%; P=0.02). CONCLUSIONS: RB was associated with fewer complications, supporting its safety profile. Although patients treated with serial cannulae required fewer reinterventions, this technique was associated with a significantly higher complication rate.