CO2 laser and Gianturco stent for endoscopic treatment of tracheal stenosis.
The self-expandable Gianturco stent was used in eleven cases of tracheal stenosis treated from September 92 to July 94. The stent is placed through a 9 mm outside diameter bronchoscope under optical control after cross-section and dilation of the stenosis with the CO2 laser according to the Shapshay technique. The follow-up varies from 3 to 22 months with a mean of 12 +/- 6 months. Pulmonary function tests (PFTs) show a mean improvement of the PEF (peak expiratory flow). Complications have been corrected in three patients with a second endoscopic procedure: the first case for malposition, the second for granuloma at the superior end of the prosthesis, and the third for the development of a mucous membrane webbing between the two loops of the stent. Owing to the lack of long-term follow-up, we reserve this technique for the treatment of severe tracheal stenosis with cartilage impairment in patients contraindicated when external reconstructive surgery is contraindicated.
Department of ENT & Head and Neck Surgery, UCL Hospital of Mont-Godinne, Yvoir, Belgium.
M
M
Remacle
G
G
Lawson
M
M
Minet
A
A
Mayne
J B
JB
Watelet
J
J
Jamart
D000368:Aged; D001999:Bronchoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D015607:Stents; D014135:Tracheal Stenosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*