Endoscopic treatment of tracheal stenosis using the carbon dioxide laser and the Gianturco stent: indications and results.
The self-expandable Gianturco stent was used in 11 patients with tracheal stenosis who where treated from September 1992 through July 1994. Under optical control, the stent was placed through a bronchoscope with an outside diameter of 9 mm after cross-section and dilation of the stenosis were performed with the carbon dioxide laser according to the Shapshay technique. The follow-up period varied from 3 to 22 months, with a mean of 12 +/- 6 months. Pulmonary function tests showed a mean improvement of the peak expiratory flow (50%), from 0.95+/-0.45 L/sec before the operation to 2.13+/-0.86 L/sec after the procedure. Radiologic and fibroscopic controls showed prosthesis stability. Three patients needed a second endoscopic procedure because of malposition of the stent, the formation of granuloma at the superior end of the prosthesis, and the development of a mucous membrane webbing between the two loops of a stent. Due to the lack of long-term follow-up, this technique is reserved for the treatment of severe tracheal stenosis with cartilage impairment in patients who have contraindications for external reconstructive surgery.
Remacle
M
M
Department of ENT and Head and Neck Surgery, UCL Hosptial Of Mont-Godinne, Yvoir, Belguim.
Lawson
G
G
Minet
M
M
Mayné
A
A
Watelet
J B
JB
Jamart
J
J
D000368:Aged; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D015607:Stents; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome