Use of silicone stents for the management of post-tuberculosis tracheobronchial stenosis

Eur Respir J. 2006 Nov;28(5):1029-35. doi: 10.1183/09031936.00020906. Epub 2006 Sep 13.

Abstract

The role of bronchoscopic management in post-tuberculosis tracheobronchial stenosis is not well defined. To investigate the role of bronchoscopic intervention, including silicone stenting, in the management of post-tuberculosis tracheobronchial stenosis, the current retrospective study was conducted at a tertiary referral hospital. Under rigid bronchoscopy, 80 patients underwent ballooning, neodymium-yttrium aluminium garnet laser resection and/or bougienation as first-line methods of airway dilatation between January 2000 and December 2003 inclusive, and were followed for a median of 41 months. Silicone stents were required in 75 out of 80 (94%) patients to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in 88% of the patients. After airway stabilisation, stents were removed successfully in 49 out of 75 (65%) patients at a median of 14 months post-insertion. Three patients out of 75 (4%) eventually underwent surgical management. Acute complications included: excessive bleeding (n = 1); pneumothorax (n = 5); and pneumomediastinum without mortality (n = 2). Stent-related late complications, such as migration (51%), granuloma formation (49%), mucostasis (19%) and re-stenosis (40%), were controllable during a median follow-up of 41 months. In conclusion, bronchoscopic intervention, including silicone stenting, could be a useful and safe method for treating post-tuberculosis tracheobronchial stenosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bronchial Diseases / etiology
  • Bronchial Diseases / therapy*
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Silicones
  • Stents* / adverse effects
  • Tracheal Stenosis / etiology
  • Tracheal Stenosis / therapy*
  • Tuberculosis, Pulmonary / complications*

Substances

  • Silicones