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Communications to the Editor |

Surveillance Bronchoscopy Following Insertion of Silicone Stents FREE TO VIEW

Prashant N. Chhajed, MD, DNB, FCCP; Monique A. Malouf, MBBS; Allan R. Glanville, MD
Author and Funding Information

St. Vincent’s Hospital Sydney, Australia

Correspondence to: Prashant N. Chhajed, MD, DNB, FCCP, Heart Lung Transplant Unit, St. Vincent’s Hospital, deLacy Building, Level 14, Victoria St, Darlinghurst NSW 2010, Sydney, Australia; e-mail: chhajed@hotmail.com



Chest. 2001;120(2):686. doi:10.1378/chest.120.2.686
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To the Editor:

We read with interest the report in CHEST by Toshiro Matsuo and Henri Colt (November 2000).1 The article addresses whether routine scheduling of flexible fiberoptic bronchoscopy is warranted 2 to 3 months after silicone stent insertion for central airway obstruction. A surveillance fiberoptic flexible bronchoscopy (SFFB) was scheduled to be performed within 2 to 3 months after the date of initial stent insertion. The onset of new respiratory symptoms prompting flexible fiberoptic bronchoscopy prior to the scheduled fiberoptic bronchoscopy was classified as an emergent fiberoptic flexible bronchoscopy (EFFB). Seventy surviving patients underwent SFFB (n = 39) or EFFB (n = 31). Of these, 39 of 70 patients (55.7%) did have new symptoms and 42 of 70 patients (60%) had evidence of complication at endoscopy. This included detection of complications in nine asymptomatic patients.

The authors do not report data regarding the postoperative day when these patients developed symptoms related to the stent or when bronchoscopy was performed. It is evident, however, that a bronchoscopy procedure (either SFFB or EFFB) was useful in >50% of the patients at 2 to 3 months after stent placement or earlier.

To our knowledge, there is no way of identifying the group at high risk of developing these complications. The authors conclude that a general policy of routine scheduling of surveillance bronchoscopy after silicone stent insertion is probably unwarranted.

We believe a different conclusion should be considered. These data could be used to estimate the mean time when these patients developed symptoms related to the stent or when bronchoscopy was performed, and to recommend that instead of leaving SFFB until 2 to 3 months after stent insertion, it should be brought forward. This would be of particular aid to patients who are referred from outside facilities to have a bronchoscopy at the time when they are most likely to have a stent-related complication, rather than waiting for symptoms to develop.

References

Matsuo, T, Colt, HG (2000) Evidence against routine scheduling of surveillance bronchoscopy after stent insertion.Chest118,1455-1459. [PubMed] [CrossRef]
 

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References

Matsuo, T, Colt, HG (2000) Evidence against routine scheduling of surveillance bronchoscopy after stent insertion.Chest118,1455-1459. [PubMed] [CrossRef]
 
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