title: Tracheobronchial Polyflex stents for the management of benign refractory hypopharyngeal strictures.
abstract: OBJECTIVE
  To describe a modified technique for placement of a tracheobronchial self-expanding plastic stent (SEPS) in patients with benign refractory hypopharyngeal strictures in order to improve dysphagia and allow stricture remodeling.
  
  
  METHODS
  A case series of four consecutive patients with complex hypopharyngeal strictures after combined therapy for laryngeal cancer, previously submitted to multiple sessions of dilation without lasting improvement, is presented. All patients underwent placement of a small diameter and unflared tracheobronchial SEPS. Main outcome measurements were improvement of dysphagia and avoiding of repeated dilation.
  
  
  RESULTS
  The modified introducer system allowed an easy and technically successful deployment of the tracheobronchial Polyflex stent through the stricture. All four patients developed complications related to stent placement. Two patients had stent migration (one proximal and one distal), two patients developed phanryngocutaneous fistulas and all patients with stents in situ for more than 8 wk had hyperplastic tissue growth at the upper end of the stent. Stricture recurrence was observed at 4 wk follow-up after stent removal in all patients.
  
  
  CONCLUSIONS
  Although technically feasible, placement of a tracheobronchial SEPS is associated with a high risk of complications. Small diameter stents must be kept in place for longer than 3 mo to allow adequate time for stricture remodeling.
authors.affiliation: Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal. rsgastro@sapo.pt
authors.forename: Rui Almeida
authors.initials: RA
authors.lastname: Silva
authors.forename: Nuno
authors.initials: N
authors.lastname: Mesquita
authors.forename: Pedro Pimentel
authors.initials: PP
authors.lastname: Nunes
authors.forename: Elisabete
authors.initials: E
authors.lastname: Cardoso
authors.forename: Ricardo Marcos
authors.initials: RM
authors.lastname: Pinto
authors.forename: Luís Moreira
authors.initials: LM
authors.lastname: Dias
mesh_terms: D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D006801:Humans; D007013:Hypopharynx / Q000473:pathology* / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome