Yonsei Med J.  2012 May;53(3):565-570. 10.3349/ymj.2012.53.3.565.

Prognostic Factors for Endotracheal Silicone Stenting in the Management of Inoperable Post-Intubation Tracheal Stenosis

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hjk3425@skku.edu

Abstract

PURPOSE
Stenting has been developed to deal with airway stenosis and is applicable in patients with post-intubation tracheal stenosis (PITS) in whom surgery would not be indicated. The purpose of this study was to investigate the prognostic factors in inoperable patients in whom a silicone stent was inserted due to PITS.
MATERIALS AND METHODS
We retrospectively evaluated 55 PITS patients undergoing silicone stenting between January 2001 and December 2009.
RESULTS
Silicone stent was inserted to narrowed trachea after the combination of pre-dilatation including laser cauterization, mechanical bougienation and ballooning. Following airway stabilization, the stent could be removed successfully in 40% (22/55) of the patients after median 12 months of stenting. However, in 60% (33/55) of patients, the stent could not be removed successfully and surgical management was needed after initial stabilization. Multivariate analysis revealed that the stent could be successfully removed more frequently in those who do not have cardiovascular disease [odds ratio (OR)=12.195; p=0.036] and the intervention was performed within 6 months after intubation (OR=13.029; p=0.031).
CONCLUSION
Among those patients undergoing silicone stenting due to PITS, the stent could be successfully removed when patients do not have cardiovascular disease and stented within 6 months after intubation.

Keyword

Intervention; post-intubation tracheal stenosis; prognosis; rigid bronchoscopy; silicone stent

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Bronchoscopy
Female
Humans
Intubation, Intratracheal/instrumentation/*methods
Male
Middle Aged
Retrospective Studies
*Stents
Tracheal Stenosis/*therapy
Young Adult

Figure

  • Fig. 1 A natural silicone stent.

  • Fig. 2 Outcomes of bronchoscopic interventions in 59 post-intubation tracheal stenosis patients.

  • Fig. 3 A representative case of temporary stenting for post-intubation tracheal stenosis. (A) Marked narrowing of the trachea was noted in a 59-year-old male patient after neurosurgical operation. (B) After silicone stent was inserted, the trachea was widened. (C) The stent was removed 1 year after the intervention. The widened diameter of trachea was maintained successfully.


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