BackgroundAirway complications following lung transplantation remain a significant cause of morbidity and mortality. The management of bronchial complications in Bronchus Intermedius (BI) is challenging due to the location of right upper bronchus. The aim of this study was to analyze the results of BI Montgomery T-tube stent in a consecutive patients with lung transplantations.MethodsBetween January 2007 and December 2010, 132 lung transplantations were performed at Foch Hospital, Suresnes, France. All the patients who had BI Montgomery T-tube after lung transplantation were included in this retrospective study. The demographic and interventional data and also complications were recorded.ResultsOut of 132 lung transplant recipients, 12 patients (9 male and 3 female) were entered into this study. The indications for lung transplantation were: cystic fibrosis 8 (67%), emphysema 3 (25%), and idiopathic pulmonary fibrosis 1 (8%). Most of the patients (83%) had bilateral lung transplantation. The mean interval between lung transplantation and interventional bronchoscopy was 11.5 ± 9.8 (SD) months. There was bronchial stenosis at the level of BI in 7 patients (58.3%). The Montgomery T-tube number 10 was used in 9 patients (75%). There was statistically significant difference in Forced Expiratory Volume in one second (FEV1) before and after stent placement (p = 0.01). The most common complication after stent placement was migration (33%).ConclusionBI complications after lung transplantation are still a significant problem. Stenosis or malacia following lung transplantation could be well managed with modified Montgomery T-tube.
Solitary pulmonary nodule (SPN) is one of the most controversial clinical findings in patients. The aim of this study is to use 99mTc-ethylenediamine diacetic acid/hydrazine nicotinamide (HYNIC)-TATE scan technique to evaluate nodules. From 2008 to 2010, 21 patients with SPN underwent 99mTc-HYNIC-TATE scan after the initial assessment with high-resolution computed tomography and then accurate histopathologic diagnosis was established by trans-thoracic needle biopsy, Video Assisted Thoracic Surgery and thoracotomy. After demographic evaluations, specificity and sensitivity of this method was studied. A total of 21 patients were included in our study, of which 12 patients were male and 9 were female. Their mean age was 45 ± 14.3 years. About 43% of the patients were symptom-free and in patients with pulmonary complaints, the most prevalent symptom was cough. Final histopathology tests and clinical follow-up proved that 14 cases (67%) were benign and 7 (33%) were malignant. The diagnostic technique used in our study had no false negative and there were only 3 cases of false positive. Sensitivity and specificity of this method are 100% and 79%, respectively and the diagnostic accuracy is 86%. 99mTc-HYNIC-TATE scan can be helpful in evaluating patients with SPN and to reach a sensible decision on the method of treatment.
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