title: Long-term tolerance of airway silicone stent in patients with post-tuberculosis tracheobronchial stenosis.
abstract: Surgery is a well-recognized modality of treatment for benign tracheobronchial stenosis. However, in some benign disease groups, such as tuberculosis, sarcoidosis, war gas exposure, and inhalation burns, multiplicity of involvement or long length of stenosed segment heightens surgical challenge. We investigated the outcomes and long-term tolerability of the Natural stent (N-stent) in such patients with post-tuberculosis tracheobronchial stenosis. A retrospective review was done for 17 patients who underwent silicone stenting (N-stent) for post-tuberculosis tracheobronchial stenosis during January 2000-December 2003 but needed persistent stent placement and still require the stent. Significant increase in the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), expressed as FEV1%, as well as in forced percentual vital capacity (FVC%) (Δ24% and Δ11%, respectively) in the short term and sustained increase in the FEV1% and FVC% (Δ26.5% and Δ16.5%, respectively) in the long term were noted at a median (range) interval of 1 (0.5-72) month and 72 (12-114) months, respectively, along with symptomatic relief. No procedure-related death occurred. Stent-related late complications included granulation tissue formation (76%), migration (70%), and mucostasis (17%). The median duration for which N-stents were tolerated was 7.9 (range, 3-11) years. N-stents are well-tolerated for a prolonged period. Stent-related complications occur, but are easily managed. These results might carry medical implications for those who have airway lesions difficult to correct surgically.
authors.affiliation: Department of Medicine, Samsung Medical Center, Division of Pulmonary and Critical Care Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Akash
authors.initials: A
authors.lastname: Verma
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Um
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001187:Artificial Organs / Q000009:adverse effects; D001980:Bronchi; D001982:Bronchial Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012828:Silicones; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D014132:Trachea; D014135:Tracheal Stenosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014397:Tuberculosis, Pulmonary / Q000150:complications; D055815:Young Adult
chemical_list: D012828:Silicones