Silicone Stents in the Management of Obstructive Tracheobronchial Lesions: 2-Year Experience

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Abstract

Nd-Yag laser resection is one of the most effective treatments of large airway obstruction. However, it is ineffective for extrinsic compression or malacia, and, in these cases, the insertion of a stent can be useful. We present our 2-years of experience with the Dumon silicone stents. A total of 125 prostheses have been placed in 90 patients, in most of the cases after laser treatment. Rigid bronchoscopy under general anesthesia was used in all patients. Indications were benign lesions in 41 cases (30 patients with 14 tracheal stenosis, 12 with tracheal stenosis with malacia, 4 with bronchial stenosis) and malignant lesions in 84 cases (60 patients with 54 bronchogenic carcinoma, 4 with esophageal carcinoma, 2 with thyroid carcinoma). Tolerance was excellent, except in one patient who expelled the stent twice. The most frequent complications were migration (17 cases), granuloma (11 cases), and hypersection (3 cases), granuloma (11 cases), and hypersecretion (3 cases). The rate of complications seems to be higher in benign pathology. In only one case the complication was life threatening (acute dyspnea needing tracheostomy). In 14 patients overgrowth of tumor was observed at follow-up and required repeated laser therapy. Six of these patients required a second stent. In our experience, silicone tracheobronchial stents are effective in the maintenance of airway patency and is associated with rapid relief of symptoms, good tolerance, and infrequent complications that are easily manageable and rarely life threatening.

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