BACKGROUND AND OBJECTIVE: The treatment choice for post-intubation tracheal stenosis (PITS) in patients for whom surgery is not initially feasible is bronchoscopic silicone stenting. A new silicone stent, called the Natural stent (N stent), was investigated for its clinical efficacy and safety in patients with PITS. METHODS: A retrospective review was conducted of 32 patients with PITS who underwent N stenting between November 2001 and December 2006 and were followed for at least 12 months. RESULTS: Airway dilatation with combined modalities such as Nd:YAG laser, ballooning or bougienage was followed by N stent insertion. After intervention, all patients had symptomatic and spirometric improvement without immediate complications. Removal of the stent without re-stenosis was successful in 38% of the patients at a median time of 7 months after insertion. The stent could not be removed or needed reinsertion in 31% of patients, and 16% of patients underwent surgery after initial stabilization by stenting. Late complications were stent migration (34%), mucostasis (31%), granulation tissue formation (38%) and re-stenosis (40%). All patients tolerated the management of complications during a median follow up of 22 months. CONCLUSIONS: Bronchoscopic N stenting is an effective treatment for patients with PITS in whom surgery is not feasible on initial presentation. Further stent development is necessary to reduce the late complication rate.
BACKGROUND AND OBJECTIVE: The treatment choice for post-intubation tracheal stenosis (PITS) in patients for whom surgery is not initially feasible is bronchoscopic silicone stenting. A new silicone stent, called the Natural stent (N stent), was investigated for its clinical efficacy and safety in patients with PITS. METHODS: A retrospective review was conducted of 32 patients with PITS who underwent N stenting between November 2001 and December 2006 and were followed for at least 12 months. RESULTS: Airway dilatation with combined modalities such as Nd:YAG laser, ballooning or bougienage was followed by N stent insertion. After intervention, all patients had symptomatic and spirometric improvement without immediate complications. Removal of the stent without re-stenosis was successful in 38% of the patients at a median time of 7 months after insertion. The stent could not be removed or needed reinsertion in 31% of patients, and 16% of patients underwent surgery after initial stabilization by stenting. Late complications were stent migration (34%), mucostasis (31%), granulation tissue formation (38%) and re-stenosis (40%). All patients tolerated the management of complications during a median follow up of 22 months. CONCLUSIONS: Bronchoscopic N stenting is an effective treatment for patients with PITS in whom surgery is not feasible on initial presentation. Further stent development is necessary to reduce the late complication rate.
Authors: Hyun Jin Kim; Sei Won Kim; Hye Yeon Lee; Hyeon Hui Kang; Ji Young Kang; Ju Sang Kim; Myung Sook Kim; Seung Soo Kim; Jin Woo Kim; Hyeong Gyu Yun; Chi Hong Kim; Kwan Hyoung Kim; Hwa Sik Moon; Kwang Jae Cho; Seok Hwan Moon; Sang Haak Lee Journal: Tuberc Respir Dis (Seoul) Date: 2012-06-29