F-T Chung1, S-M Lin, C-L Chou, H-C Chen, C-Y Liu, C-T Yu, H-P Kuo. 1. Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan. vikingchung@yahoo.com.tw
Abstract
BACKGROUND: This retrospective study aimed to determine the factors leading to obstructive granulation tissue formation after the placement of a self-expandable metallic stent (SEMS) in patients with benign tracheal disease. METHODS: From 2001 to 2007, a total of 67 patients (age: 62.1 +/- 15.4 years; range: 23-87 years) with benign tracheal disease received 75 ultraflex SEMS in our institution. RESULTS: There were 35 SEMSs complicated by obstructive granulation tissue formation out of the 75 stents placed in patients with tracheal disease, giving an incidence of 47.8 % (32/67 patients). The median time until developing granulation tissue was 106 days (IQR, 46-396). Structural airway obstruction prior to SEMS implantation independently predicted obstructive granulation tissue formation after SEMS implantation (odds ratio: 3.84; 95 % CI: 1.01-8.7; P = 0.04). Time to granulation tissue detection was shorter in patients with structural airway obstruction before SEMS implantation (structural airway obstruction vs. dynamic collapse airway: median [IQR] 95 [38-224, n = 26] vs. 396 days [73-994, n = 9]; P = 0.02). CONCLUSIONS: Obstructive granulation tissue formation is not uncommon after SEMS implantation and structural airway obstruction prior to SEMS implantation is an independent predictor. Although SEMS implantation should be restricted to a select population, it may be placed in patients not suitable for surgical intervention or rigid bronchoscopy with anesthesia because of poor pulmonary function.
BACKGROUND: This retrospective study aimed to determine the factors leading to obstructive granulation tissue formation after the placement of a self-expandable metallic stent (SEMS) in patients with benign tracheal disease. METHODS: From 2001 to 2007, a total of 67 patients (age: 62.1 +/- 15.4 years; range: 23-87 years) with benign tracheal disease received 75 ultraflex SEMS in our institution. RESULTS: There were 35 SEMSs complicated by obstructive granulation tissue formation out of the 75 stents placed in patients with tracheal disease, giving an incidence of 47.8 % (32/67 patients). The median time until developing granulation tissue was 106 days (IQR, 46-396). Structural airway obstruction prior to SEMS implantation independently predicted obstructive granulation tissue formation after SEMS implantation (odds ratio: 3.84; 95 % CI: 1.01-8.7; P = 0.04). Time to granulation tissue detection was shorter in patients with structural airway obstruction before SEMS implantation (structural airway obstruction vs. dynamic collapse airway: median [IQR] 95 [38-224, n = 26] vs. 396 days [73-994, n = 9]; P = 0.02). CONCLUSIONS: Obstructive granulation tissue formation is not uncommon after SEMS implantation and structural airway obstruction prior to SEMS implantation is an independent predictor. Although SEMS implantation should be restricted to a select population, it may be placed in patients not suitable for surgical intervention or rigid bronchoscopy with anesthesia because of poor pulmonary function.
Authors: David E Ost; Archan M Shah; Xiudong Lei; Myrna C B Godoy; Carlos A Jimenez; George A Eapen; Pushan Jani; Andrew J Larson; Mona G Sarkiss; Rodolfo C Morice Journal: Chest Date: 2011-12-22 Impact factor: 9.410
Authors: Sung Bae Cho; Seon Ah Cha; Joon Young Choi; Jong Min Lee; Hyeon Hui Kang; Hwa Sik Moon; Sei Won Kim; Chang Dong Yeo; Sang Haak Lee Journal: Tuberc Respir Dis (Seoul) Date: 2015-01-29
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