title: The role of T-tubes in the management of airway stenosis.
abstract: OBJECTIVE
  When the T-tube is inserted as a temporary stent, it is unclear whether keeping it longer in place has any benefit on the outcome.
  
  
  METHODS
  Among 1738 patients with airway stenosis (1996-2011), 134 underwent T-tube placement (mean duration = 14.3 months); temporarily while waiting for an appropriate time for surgery in 53 (Group 1), as an adjunct after a complex laryngotracheal resection in 27 (Group 2), after surgical failure in 43 (Group 3) and permanently in 11 unresectable strictures (Group 4). A logistic regression model was used for statistical analysis.
  
  
  RESULTS
  Seventy percent of patients were males (age = 33.6 ± 17 years). The main cause was postintubation/post-tracheostomy stenosis in 87% of patients. The stenosis (29.6 ± 14 mm, 5-80 mm) was located in the subglottis in 33%, trachea in 47% and both in 20% of cases. To assess the effect of T-tubes on stabilizing the airway after decannulation, 50 patients who still had a T-tube at the end of follow-up or for <1.5 months were excluded. Of the remaining 84, 31.5, 91.5 and 32.5% of patients in Groups 1, 2 and 3 were stable at least 3 months after decannulation. Moreover, 70% of those who were decannulated at or before 6 months and 53.7% of those who were decannulated after 6 months underwent another intervention (P = 0.17). The age, sex, cause, site of stenosis and even duration of T-tube insertion (P = 0.07) showed no significant effect on the decannulation outcome.
  
  
  CONCLUSIONS
  Although it seems that keeping the T-tube in place for >6 months may increase the chance of successful decannulation, it was not confirmed in our study.
authors.affiliation: Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Reza
authors.initials: SR
authors.lastname: Saghebi
authors.forename: Mahdi
authors.initials: M
authors.lastname: Zangi
authors.forename: Tissa
authors.initials: T
authors.lastname: Tajali
authors.forename: Roya
authors.initials: R
authors.lastname: Farzanegan
authors.forename: Seyed Mehdi
authors.initials: SM
authors.lastname: Farsad
authors.forename: Azizollah
authors.initials: A
authors.lastname: Abbasidezfouli
authors.forename: Kambiz
authors.initials: K
authors.lastname: Sheikhy
authors.forename: Mohammad Behgam
authors.initials: MB
authors.lastname: Shadmehr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060666:Airway Extubation / Q000295:instrumentation / Q000379:methods; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D020878:Device Removal; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D014135:Tracheal Stenosis / Q000517:prevention & control / Q000628:therapy*; D014139:Tracheostomy / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome