title: Bronchoscopic Treatment in the Management of Benign Tracheal Stenosis: Choices for Simple and Complex Tracheal Stenosis.
abstract: BACKGROUND
  Bronchoscopic treatment is 1 of the treatment choices for both palliative and definitive treatment of benign tracheal stenosis. There is no consensus on the management of these patients, however, especially patients having complex stenoses. The aim of the present study was to assess, in the largest group of patients with complex stenoses yet reported, which types of tracheal stenosis are amenable to optimal management by bronchoscopic treatment.
  
  
  METHODS
  The present study was a retrospective cohort study including 132 consecutive patients with benign tracheal stenoses diagnosed between August 2005 and January 2013. The mean age of the study population was 52 ± 18 years; 62 (47%) were women and 70 (53%) were men. Their lesions were classified as simple and complex stenoses.
  
  
  RESULTS
  Simple stenoses (n = 6) were treated with 12 rigid and flexible bronchoscopic procedures (mean of 2 per patient); 5 stents were placed. The total success rate was 100%. Among the 124 complex stenoses, 4 were treated directly with surgical intervention. In total, 481 rigid and 487 flexible bronchoscopic procedures were performed in these patients. In this group, the success rate was 69.8%.
  
  
  CONCLUSIONS
  From the present study, we propose that after accurate classification, interventional bronchoscopic management may have an important role in the treatment of benign tracheal stenosis. Bronchoscopic treatment should be considered as first-line therapy for simple stenoses, whereas complex stenoses need a multidisciplinary approach and often require surgical intervention. However, bronchoscopic treatment may be a valid conservative approach in the management of patients with complex tracheal stenosis who are not eligible for operative treatment.
authors.affiliation: Department of Pulmonary Medicine, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey. Electronic address: leventdalar@gmail.com.
authors.forename: Levent
authors.initials: L
authors.lastname: Dalar
authors.affiliation: Interventional Pulmonology Unit, Yedikule Thoracic Diseases and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Karasulu
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Abul
authors.affiliation: Interventional Pulmonology Unit, Yedikule Thoracic Diseases and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Özdemir
authors.affiliation: Interventional Pulmonology Unit, Yedikule Thoracic Diseases and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Sinem Nedime
authors.initials: SN
authors.lastname: Sökücü
authors.affiliation: Interventional Pulmonology Unit, Yedikule Thoracic Diseases and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Tarhan
authors.affiliation: Interventional Pulmonology Unit, Yedikule Thoracic Diseases and Thoracic Surgery Hospital, Istanbul, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Altin
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012131:Respiratory Insufficiency / Q000209:etiology / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D014139:Tracheostomy / Q000009:adverse effects; D016896:Treatment Outcome