Original articleGeneral thoracicDecannulation in Tracheal Stenosis Deemed Inoperable Is Possible After Long-Term Airway Stenting
Section snippets
Patients and Methods
This was a retrospective cohort study conducted at an academic reference center for tracheal diseases with an outpatient clinic performing between 30 and 40 consultations per week. All patients who received silicone tracheal stents in our institution from January 1998 to December 2008 were included. This cohort included only patients with benign tracheal stenosis who were treated with tracheal stents exclusively; patients with neoplastic invasion of the trachea, stenting before airway
Results
Two hundred six patients were treated with silicone tracheal stents during the study period. All patients undergoing stenting were followed up at the tracheal surgery outpatient clinic. The flowchart of the study is shown in Figure 2. Ninety-two individuals were included in the study, and the patients' demographics are given in Table 1.
Patients were considered inoperable because of long segment tracheal stenosis in 38 patients (41%), high surgical risk in 42 (46%), and 12 (13%) who had to
Comment
In the present study we observed that long-term airway stenting allowed successful decannulation in 27.5% of the patients considered not eligible for tracheal resection over a 60-month period. Tracheostomy was the sole significant factor for decannulation and led to a threefold increase in the likelihood of a patient's remaining with a tracheal stent.
Cure of benign tracheal stenosis after long-term airway stenting is controversial but has been cited in pivotal articles. In a report by Cooper
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2021, Annals of Thoracic SurgeryCitation Excerpt :Complete resolution of tracheal stenosis treated exclusively with silicone stents remains controversial. We have demonstrated that long-term airway stenting allowed decannulation in 27.5% of patients considered ineligible for tracheal resection over a 60-month period.5 We hypothesize that successful treatment by stenting could be related to the preservation of tracheal cartilage that maintains the airway diameter and wall stability.
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2019, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :The data collected for sample characterization included age, sex, BMI, symptoms (dyspnea, dysphonia, heartburn, acid regurgitation, phlegm, dysphagia, stridor, globus), presence of lower esophageal or body sphincter hypotonia, presence of supraesophageal reflux, DeMeester score, presence of tracheostomy, recurrence of previous treatment of the stenosis, and other treatment used for the tracheal stenosis. Favorable outcome of the tracheal stenosis was considered when at completion of the 2-year follow-up the patient achieved 1 of the following conditions: stability of the stenosis not requiring further dilatation or allowing for definitive decannulation using standardized criteria12 or tracheal resection was performed successfully according to endoscopic and radiology assessment. Unfavorable outcome was considered when none of those outcomes were achieved after 2 years of follow-up.
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2016, Annals of Thoracic SurgeryCitation Excerpt :In our series, 4 patients had tracheal stents before the operation. Endoscopic placement of tracheal stents adds little damage to the tracheal wall and allows phonation and humidification of the upper airways [16, 17]. The decision to place preoperative tracheal stents was individualized.