PURPOSE:To evaluate the long-term outcome of tracheal stents in tracheal stenosis management.
METHODS:Retrospective analysis of all patients that underwent tracheal stent insertion in our institution from 2000 to 2006. In our facility, tracheal stents are used only in patients with inoperable stenosis due to stenosis features or patients‘ clinical conditions. Patients were divided in groups according to the device inserted: t-tube (TT), rigid silicone stent (Dumon –DU) and self-expandable silicone stent (Polyflex –PF).
RESULTS:During the study period, 156 (94 male, 61 female, mean age 35.2 years) patients underwent 387 stent placements (328 TT, 27 DU, 32 PF). Tracheal stenosis etiologies were: orotracheal intubation (82%), neoplasms (7.7%) and other (10.3%). Mean time with stent in place was 282 days. 41.3% of the patients had only one stent, but 26.5% had 4 or more stents inserted. Size adjustment requirement and stent deterioration justified 84% of stents changes. The main complications were as follows: granuloma (19.7%), secretion/infection/odor (17.6%) and migration (8.1%). DU and PF had a higher complication rate particularly migration. Definitive stent withdrawal was observed in 37.6% of the patients in a mean time of 20 months. 50% of the patients were still on prosthesis at the data collection end (30 months, mean follow-up).
CONCLUSION:Long term stenting allowed definitive withdrawal in a significant number of patients; however in many of them several stent change procedures were required. T-tube had the lower complication rate.
CLINICAL IMPLICATIONS:Long term stenting is an option for inoperable tracheal stenosis treatment and allows definitive stent withdrawal in 37.6% of the patients.
DISCLOSURE:Ricardo Terra, No Financial Disclosure Information; No Product/Research Disclosure Information