The Role of Tracheal Stenting As an Alternative Treatment in Cicatricial and Non-Operable Tracheal Stenosis

Document Type : Original Article

Authors

1 Thoracic surgeon , Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Thoracic surgeon, Valiasr Hospital, Tehran, Iran

3 Thoracic surgeon, Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Medical student

Abstract

 
Introduction:
Tracheal stenosis is normally caused by trauma, infection, benign and malignant tumors, prolonged intubation or tracheostomy. The best treatment for tracheal stenosis is resection and anastomosis of trachea. Yet the major surgical complication of tracheal surgery is postoperative stenosis. The goal of this paper is to study the result of tracheal stenting as a replacement therapy for patients suffering from tracheal stenosis who are not good candidates for surgery.
 
Materials and Methods:
This study presents the results of stenting in patients with: Inoperable tumoral stenosis,Non-tumoral stenosis being complicated due to prior surgeries,Inability to undergo a major surgery.The study was performed between September 2002 and July 2011 and poly flex stents were used by means of rigid bronchoscopy.
Results:
A total of 25 patients received stents during this study. Among them 15 patients suffered from benign and 10 suffered from malignant tracheal stenosis. The patients were followed up for at most 12 months after the stenting operation. The mean age of the patients was 35 years. The most common cause of stenosis was prolonged intubation (75%). The most common indication for stenting was the history of multiple tracheal operations. The most common complication of stenting and cause of stent removal was formation of granulation tissue. 30% of patients with benign tracheal stenosis were cured and about 10% improved until they could stand a major operation. Ten patients in benign group and 2 patients in malignant group (20%) needed T-Tube insertion after stent removal but other patientcure by stenting.
Conclusions:
In benign cases stenting is associated with recurrence of symptoms which requires other therapeutic techniqus, so the stenting may not be named as a final solution in benign cases. However, this technique is the only method with approved efficacy for malignant cases with indication.

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