Study objectives: To determine whether routine
scheduling of surveillance flexible fiberoptic bronchoscopy is
warranted within 2 to 3 months after silicone stent insertion for
central airway obstruction.
Setting: University medical center.
Patients: All patients with silicone stents placed for
benign or malignant tracheobronchial obstruction during a 3-year
Methods: Incidence of stent-related
complications, new respiratory symptoms, and need for therapeutic
bronchoscopic intervention were noted in patients undergoing
surveillance bronchoscopy (SFFB) and emergency bronchoscopy (EFFB),
defined as flexible fiberoptic bronchoscopy prompted by onset of new
symptoms before the date of scheduled SFFB.
One hundred one silicone stents were inserted in 88 patients (47 with
cancer, 41 with benign disease). Eighteen patients died within 2 months
and had no bronchoscopy. Seventy patients underwent either SFFB or
EFFB. Stent-related complications were detected in 9 of 31 asymptomatic
patients (29%) undergoing SFFB; all had received tumor-specific
therapy after stent insertion (in 7 of 8 patients [88%] reporting
new respiratory symptoms at the time of SFFB, and in 26 of 31 patients[
84%] undergoing EFFB). Overall, stent-related complications were
detected in nine asymptomatic patients (10% of total), of which only
four patients (5% of total, but 13% of all asymptomatic patients)
required therapeutic interventions.
Routine SFFB within 2 to 3 months after stent insertion did not detect
a high incidence of stent-related complications among patients without
new respiratory symptoms.