BAPS PaperLong-term outcomes of congenital tracheal stenosis treated by metallic airway stenting
Section snippets
Materials and methods
Five infants had been treated for congenital tracheal stenosis with severe airway obstruction between 1997 and 2000 in our institution. Informed consent was obtained for the procedure after outlining all potential complications, including airway perforation, infection, dislodgement, and obstruction.
The diagnosis of congenital tracheal stenosis was confirmed by bronchoscopy and bronchography with all procedures performed under general anesthesia with a Storz rigid bronchoscope. The balloon
Results
The study group consisted of five infants with a median age at the time of the initial procedure of 5 (range 2–12) months. In all five cases, there was immediate improvement of respiratory obstruction, and four could be weaned from ventilation. One child died after 9 months of palliation. Inflammation and granulation tissue developed over the stents in all children but could be satisfactorily managed by scraping or balloon compression.
Metallic stents have now been in place for a median of 13 years
Discussion
Airway obstruction in children is a rare, but difficult clinical problem, with no clear agreement on optimal therapeutic approach. Metallic expandable stenting of the airway had been introduced an attractive alternative in children in the 1990s [2], [3], [4], [5], [6], [7] with the aim of achieving airway patency and stabilizing tracheomalacia.
The treatment of congenital tracheal stenosis is still a challenge and we previously introduced a technique utilizing balloon dilatation and the
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Cited by (28)
Anatomic Disorders of the Chest and Airways
2023, Avery's Diseases of the NewbornReactivity Study of a Biodegradable Polydioxanone Tracheal Stent in a Rabbit Model
2020, Archivos de BronconeumologiaA combination of tracheoplasty and tracheal stenting is an acceptable method of treating severe congenital tracheobronchial stenosis under extracorporeal membrane oxygenation
2019, Journal of Pediatric SurgeryCitation Excerpt :In practice, it should be regarded as a temporizing preoperative measure, and with the availability of ECMO at specialized centers, it should be performed judiciously. Metallic stent placement in the pediatric airway for CTBS has been considered last treatment resort in patients with residual airway malacia after tracheoplasty or in patients unsuitable for surgery [1,2,11,13,14]. Ideally, postoperative transient stenting of the collapsing airway, preferably with biodegradable stents, can provide sufficient time window for pediatric patients to be weaned from sedation and support the trachea while the repair stabilizes through fibrosis [2,15].
Surgical management of children presenting with surgical-needed tracheal stenosis
2018, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :Laser could be associated with balloon dilation on stenosis extended to 2 to 3 rings maximum (1 cm). Tracheal stenting should be performed as a last option [23,24]. Our series does not reflect all the possibilities previously described in the literature.
Pediatric Interventional Pulmonology
2018, Clinics in Chest MedicineCitation Excerpt :The major disadvantages of these stents are granulation and epithelialization around and inside the stent making stent removal difficult and high risk. Although infrequent, open surgery is required for removal of these stents.43–45 Frequently these stents require repeated bronchoscopies to recanalize the stents by removing secretions and granulation blocking the stent.
Surgical Disorders of the Chest and Airways
2018, Avery's Diseases of the Newborn: Tenth Edition