In a medical feat, surgery was performed in the city to repair windpipe of a 22-year-old girl suffering from an extremely rare medical condition called ‘Multi-level tracheal and bronchial stenosis’.
Dr Sameer Arbat, who repaired the windpipe, told TOI that the girl complained of shortness of breath and fall in oxygen levels. She had been undergoing treatment for bronchial asthma for the past one year.
“A CT scan of the thorax revealed ‘Multi-level tracheal and bronchial stenosis’. It means narrowing of the windpipe at different levels which was not letting her breathe,” said Dr Arbat.
Multi level stenosis or narrowing of airway is a very rare condition encountered in less than 1% of world population. In this girl’s case, the trachea or main windpipe had only a pin hole opening at the level of narrowing, thus obstructing 95% of air supply to both the lungs. Complicating the condition was 70% narrowing of right lung windpipe and 40% narrowing of left lung windpipe.
“The narrowing had also led to stagnation of secretions in both lungs, causing pneumonia of right and left lung. Without non-invasive ventilation support, she was unable to breathe,” said Dr Arbat.
The team of doctors decided to perform procedure of multi level tracheal dilatation and Y stent installation inside the windpipe. The surgery was conducted at Wockhardt Hospitals.
The three-hour long procedure started by opening up the pin hole narrowing by cutting it with heated knife. Multiple sessions of sequential ballon dilatation were performed to open the narrowing at three different levels. Dimensions of the patient’s windpipe was measured and a silicone Y stent was customised. The stent was deployed to keep the windpipe open and prevent it from narrowing again.
The patient was discharged after reporting relief from complaints and is keeping healthy even one month after the procedure.
Tracheal stents are rarely used and are still undergoing evolution in terms of sizes and materials. According to the records with lung specialists’ association, it was the first case of Silicone Y stent installation in Central India, and only the third in the country in the past three years.
“I have performed several metallic Y Stent placements in patients of lung cancer but this was the first Silicone Y stent deployed in a young patient with benign condition,” said Dr Arbat adding that it could not have been possible without the support of anaesthetist and OT team at Wockhardt Hospitals.
Dr Sameer Arbat,
Wockhardt Hospitals, Nagpur
