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Ricardo M. Terra, *; Benoit J. Bibas, MD; Helio Minamoto, PhD; Daniel R. Waisberg; Miguel L. Tedde, PhD; Fabio B. Jatene, PhD
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University of Sao Paulo, Sao Paulo, Brazil


Chest. 2009;136(4_MeetingAbstracts):28S. doi:10.1378/chest.08-2448
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PURPOSE:  Evaluate long-term decannulation rate and its predictive factors for patients with benign TS deemed to be inoperable for whom silicone stents were considered definitive treatment.

METHODS:  Retrospective analysis of all patients who underwent tracheal stents implantation as definitive treatment for benign TS in our facility from January/98 until January/08. We considered successful decannulation when 6 months after the stent removal the patient remained free of symptoms and no additional dilatational procedure was required. Predictive factors analyzed were: gender, age, stenosis features (according to CT scan/bronchoscopy), previous tracheostomy, time interval from TS diagnosis and stenting.

RESULTS:  92 patients (60 men, 32 women), age average 38.7 ± 18 years, were included. TS etiology was prolonged orotracheal intubation (84) and other(8). Surgical treatment was precluded because of severe clinical comorbidities (41), long segment-stenosis (37) or they were waiting for other interventions under general anesthesia (12). Average TS distance from vocal folds was 2.6±1.3 cm and average TS length, 4.3±1.5 cm. Sixty-five patients underwent T-tube insertion, 15 a Dumon stent and 12 both (during their follow-up). They underwent an average of 2.6 stent changes. Twenty-one patients were decannulated after a mean time of 25±18 months; nevertheless two of them were recannulated after 6 months. None of the factors discriminated in the method section correlated with successful decannulation. The mean follow-up time was 50.9±35.7 months, there was no difference in follow-up time between those who were decannulated or not. Currently 63 patients are still being followed (12 of them decannulated), 20 were lost to follow-up (8 decannulated) and 9 died (of unrelated causes).

CONCLUSION:  Tracheal stenting for benign TS demands several interventions (stent changes) and is associated with a low decannulation rate. No predictive factor of success was identified in the present study.

CLINICAL IMPLICATIONS:  This long-term study on tracheal stenting for benign TS demonstrated that this procedure has a low rate of decannulation and that demographic and stenosis features can not predict the outcome. Hence, new strategies should be developed for long-term resolution.

DISCLOSURE:  Ricardo Terra, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

10:30 AM - 12:00 PM




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