Tracheal resection at "QSR Tirana Shefqet Ndroqi" was successfully performed on a 30-year-old patient diagnosed with severe tracheal stenosis and tracheo-esophageal fistula, as a result of prolonged intubation, announced Prime Minister Edi Rama. In a post on Facebook, he wrote that in this very complex intervention that is performed only in highly specialized clinics around the world, the patient underwent a three-centimeter resection of the upper part of the trachea and a successful tracheo-laryngeal anastmosis was performed. The Albanian Prime Minister expressed his gratitude to the team of doctors and nurses who were part of this operation.

Tracheal resection and reconstruction (TRR) and laryngotracheal resection and reconstruction (LTRR) are commonly performed for post-intubation tracheal stenosis, tracheal tumor, idiopathic laryngotracheal stenosis (ILTS), and tracheoesophageal fistula (TEF). Complications include granulation tissue formation, tracheal restenosis, anastomotic separation, TEF and tracheoinnominative fistula (TIF), wound infection, laryngeal edema, and glottic dysfunction. Risk factors for anastomotic complications include diabetes, reoperation, previous tracheal device, and long-segment tracheal resection.

Bronchoscopy should be part of the diagnostic workup when a complication is suspected. Anastomotic separation—the most feared complication of tracheal surgery—can present subtly with stridor and wound infection, or with extreme respiratory distress. Immediate management is required to prevent devastating consequences. The airway should be secured, bronchoscopy should be performed to address the degree of separation, and the anastomosis should be revised if necessary, usually with the addition of a t-tube or tracheostomy. Anastomotic complications that are managed aggressively usually have good outcomes. More than half of such patients will eventually have a satisfactory airway. However, an anastomotic complication is associated with a thirteenfold increased risk of death after tracheal resection.

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