title: The role of silicone stents in the treatment of cicatricial tracheal stenoses.
abstract: OBJECTIVE
  Tracheal stenting for cicatricial stenoses is reserved for patients whose lesions are deemed inoperable for local or general reasons. The aim of our study was to verify the long-term results of silicone tracheal stents in such a clinical setting.
  
  
  METHODS
  Clinical data of 45 patients treated by tracheal silicone stents, between 1987 and 1999, were reviewed. All patients had highly symptomatic cicatricial stenoses; they were selected for stenting rather than for surgery because of local and general conditions. This series has been divided in two groups according to the purpose of stenting: bridge to surgery or definitive treatment. Follow-up ranged between 12 and 83 months. Twenty-seven patients received a Montgomery T tube (Hood Laboratories, Pembroke, Mass), 16 a Dumon stent (Novatech, Plan de Gras, France), and 2 a Dynamic stent (Rusch, Kernen, Germany).
  
  
  RESULTS
  No procedure-related mortality was observed. Nine patients underwent curative resection and reconstruction after a variable stenting period; one had a recurrent stenosis and was treated for palliation with a T tube. Tracheal stenting was performed for palliation as a definitive treatment in 37 patients. Among this group, 11 patients died of unrelated causes at a median of 10 months after the endoscopic treatment. The stent was permanently removed in 10 after a median interval of 32 months (range 9-70 months); in 4 others, symptomatic recurrence of the stenosis was observed within 6 weeks of stent removal. None of the patients successfully decannulated had a completely normal tracheal lumen but all remained asymptomatic because the residual stenosis was mild or well tolerated for concomitant limitation of physical activity.
  
  
  CONCLUSIONS
  Long-term treatment with a silicone stent was safe and well tolerated in cicatricial tracheal stenoses. This procedure can be considered as a bridge to curative surgery or as a definitive treatment. The latter, generally performed for palliation, may provide satisfactory therapeutic results in selected patients, even in the presence of severe circumferential stenoses.
authors.affiliation: Clinica Chirurgica Generale e Toracica, University of Perugia Medical School, Ospedale Civile di Terni, Terni, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Puma
authors.forename: M
authors.initials: M
authors.lastname: Ragusa
authors.forename: N
authors.initials: N
authors.lastname: Avenia
authors.forename: M
authors.initials: M
authors.lastname: Urbani
authors.forename: A
authors.initials: A
authors.lastname: Droghetti
authors.forename: N
authors.initials: N
authors.lastname: Daddi
authors.forename: G
authors.initials: G
authors.lastname: Daddi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002921:Cicatrix / Q000145:classification / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012008:Recurrence; D012720:Severity of Illness Index; D012828:Silicones; D015607:Stents; D013997:Time Factors; D014135:Tracheal Stenosis / Q000145:classification / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D012828:Silicones