title: Use of silicone stents for the management of post-tuberculosis tracheobronchial stenosis.
abstract: 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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Dept of Internal Medicine, Dongdaemun Hospital, Ewha Womans University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Ryu
authors.forename: H
authors.initials: H
authors.lastname: Kim
authors.forename: C M
authors.initials: CM
authors.lastname: Yu
authors.forename: J C
authors.initials: JC
authors.lastname: Choi
authors.forename: Y S
authors.initials: YS
authors.lastname: Kwon
authors.forename: O J
authors.initials: OJ
authors.lastname: Kwon
mesh_terms: 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*
chemical_list: D012828:Silicones