Use of silicone stents for the management of post-tuberculosis tracheobronchial stenosis.
The role of bronchoscopic management in post-tuberculosis tracheobronchial stenosis is not well defined. To investigate the role of bronchoscopic intervention, including silicone stenting, in the management of post-tuberculosis tracheobronchial stenosis, the current retrospective study was conducted at a tertiary referral hospital. Under rigid bronchoscopy, 80 patients underwent ballooning, neodymium-yttrium aluminium garnet laser resection and/or bougienation as first-line methods of airway dilatation between January 2000 and December 2003 inclusive, and were followed for a median of 41 months. Silicone stents were required in 75 out of 80 (94%) patients to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in 88% of the patients. After airway stabilisation, stents were removed successfully in 49 out of 75 (65%) patients at a median of 14 months post-insertion. Three patients out of 75 (4%) eventually underwent surgical management. Acute complications included: excessive bleeding (n = 1); pneumothorax (n = 5); and pneumomediastinum without mortality (n = 2). Stent-related late complications, such as migration (51%), granuloma formation (49%), mucostasis (19%) and re-stenosis (40%), were controllable during a median follow-up of 41 months. In conclusion, bronchoscopic intervention, including silicone stenting, could be a useful and safe method for treating post-tuberculosis tracheobronchial stenosis.
Ryu
Y J
YJ
Division of Pulmonary and Critical Care Medicine, Dept of Internal Medicine, Dongdaemun Hospital, Ewha Womans University, College of Medicine, Seoul, Republic of Korea.
Kim
H
H
Yu
C M
CM
Choi
J C
JC
Kwon
Y S
YS
Kwon
O J
OJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012828:Silicones; D015607:Stents / Q000009:adverse effects; D014135:Tracheal Stenosis / Q000209:etiology / Q000628:therapy*; D014397:Tuberculosis, Pulmonary / Q000150:complications*
D012828:Silicones