Levent Dalar1, Levent Karasulu2, Yasin Abul3, Cengiz Özdemir2, Sinem Nedime Sökücü2, Merve Tarhan2, Sedat Altin2. 1. Department of Pulmonary Medicine, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey. Electronic address: leventdalar@gmail.com. 2. Interventional Pulmonology Unit, Yedikule Thoracic Diseases and Thoracic Surgery Hospital, Istanbul, Turkey. 3. Department of Pulmonary and Critical Care Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
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.
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: Victoria K Pepper; Ekene A Onwuka; Cameron A Best; Nakesha King; Eric Heuer; Jed Johnson; Christopher K Breuer; Jonathan M Grischkan; Tendy Chiang Journal: Laryngoscope Date: 2017-03-27 Impact factor: 3.325
Authors: Justin M Karush; Christopher W Seder; Anish Raman; Gary W Chmielewski; Michael J Liptay; William H Warren; Andrew T Arndt Journal: Lung Date: 2017-06-16 Impact factor: 2.584
Authors: Tuhina Raman; Kshitij Chatterjee; Bashar N Alzghoul; Ayoub A Innabi; Ozlem Tulunay; Thaddeus Bartter; Nikhil K Meena Journal: SAGE Open Med Case Rep Date: 2017-06-06