Interventional endoscopy in the management of benign tracheal stenoses: definitive treatment at long-term follow-up

Galluccio, Giovanni; Lucantoni, Gabriele; Battistoni, Paolo; Paone, Gregorino; Batzella, Sandro; Lucifora, Vito; Iacono, Raffaele Dello

doi:10.1016/j.ejcts.2008.10.041

Cited by 152 publications

(173 citation statements)

References 13 publications

Supporting

Mentioning

150

Contrasting

Unclassified

Order By: Relevance

“…1,4,6,7,9) In case of performing tracheostomy, making too large stoma and inserting large tube through small stoma could damage cartilage which causes stenosis at the stoma site. 5) Although there have been different approaches to treat the TS, such as airway stent insertion, balloon dilatation, laser therapy, tracheal reconstruction and airway transplantation, 3,7,[10][11][12] TRE have shown good results in several centers and have accepted the standard treatment of TS. 2,7,[13][14][15] In some cases of involving subglottis, challenging surgical techniques and minor modifications are necessary.…”

Section: Resultsmentioning

confidence: 99%

Surgical Outcomes of Post Intubational or Post Tracheostomy Tracheal Stenosis: Report of 18 Cases in Single Institution

Ahn

Cho

Kim

et al. 2015

ATCS

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Surgical Outcomes of Post Intubational or Post Tracheostomy Tracheal Stenosis: Report of 18 Cases in Single Institution

Ahn

Cho

Kim

et al. 2015

ATCS

View full text Add to dashboard Cite

“…The web-like PITTS is generally successfully treated by radial mucosal incisions followed by mechanical dilation [46]. The rate of success is close to 90%, in one to three sessions [47]. For the complex PITTS, mechanical dilation alone is often not sufficient [45].…”

Section: Benign Airway Stenosis Post-intubation or Post-tracheostomy mentioning

confidence: 99%

The use of self-expandable metallic stents in the airways in the adult population

Dutau¹,

Musani

Plojoux³

et al. 2014

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

The airway stents restore patency in the face of luminal compromise from intrinsic and/or extrinsic pathologies. Luminal compromise beyond 50% often leads to debilitating symptoms such as dyspnea. Silicone stents remain the most commonly placed stents worldwide and have been the "gold standard" for the treatment of benign and malignant airway stenoses over the past 20 years. Nevertheless, silicone stents are not the ideal stents in all situations. Metallic stents can serve better in some selected conditions. Unlike silicone stents, there are large and increasing varieties of metallic stents available on the market. The lack of prospective or comparative studies between various types of metallic stents makes the choice difficult and expert-opinion based. International guidelines are sorely lacking in this area.KEYWORDS: airway stenting . benign airway stenosis . bronchoscopy . central airway obstruction . self-expandable metallic stentDumon was the first physician to place a dedicated and specially designed airway stent in 1987 in Marseille. This dedicated stent consisted of a silicone tube with small studs on the external surface to reduce migration [1]. Consequently, several companies started to develop other airway stents with silicone and metal. In the last 20 years, numerous reports have been published about the use of selfexpanding and balloon expandable metal stents for the treatment of tracheobronchial malignant and benign stenoses, tracheobronchomalacia (TBM), fistulas and dehiscences [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].Self-expandable stents are made of a shapememory alloy, generally nitinol (nickel-titanium). When the stent is released, it expands spontaneously to reach its original shape and diameter. On the other hand, balloon expandable metallic stents (the first generation of airway metallic stents) were made of metal (steel) meshes that did not possess a memory shape. A balloon was then necessary to deploy them. Most of these stents had originally been developed for use in the vascular system but were found to be adequate for placement in the central airways after only minor modifications, if any at all. The latest developments include stents made of shape memory alloys and composite stents made from metals and polymers [17][18][19]. But, so far, the Dumon stent (Tracheobronxane Ò , Novatech, La Ciotat, France) remains the most commonly placed stent worldwide. Dumon stents have been the 'gold standard' for the treatment of benign and malignant airway stenoses over the past 20 years [20,21], with two specific designs: straight and Y-shaped (for disease involving the carina) [22]. By the way, it is interesting to notice that, in the Thoracic Endoscopy Unit of Marseille, where the Dumon stent was conceptualized and used, the percentage of silicone stent placement has dropped from 100% in 2000 to 65% in 2013. The remaining 35% of the stents used are now fully covered, selfexpandable, metallic stents (SEMS). This goes to prove that the Dumon stents are not the ideal stents in all situa...

show abstract

“…Dilatation, laser photo resection, and stent placement are the mainstay of endoscopic treatment strategy and afford excellent clinical results. An attempt to definitively remove the stent after 12 to 18 months is generally provided with variable longterm success (40% when the stent is placed for 6 months,70% when it remains in place for 18 months) [12,[20][21][22]. Restenosis after stent removal is reported in up to 80%, requiring permanent stent placement or second line surgery [20].…”

mentioning

confidence: 99%

“…Patients suffering from DATS are frequently excluded from studies describing endoscopic management of BTS [12,[20][21][22]24]. As a matter of fact, DATS are not treatable with dilatation as there is no shrinking or scarring of trachea.…”

mentioning

confidence: 99%

“…However, some patients are not considered candidates for surgery because of the extent of the stenosis (> 50% of the trachea or multifocal involvement) or because of any surgical contraindication. Endoscopic techniques have been developed as an alternative treatment [12,[18][19][20][21][22][23][24][25][26]. Dilatation, laser photo resection, and stent placement are the mainstay of endoscopic treatment strategy and afford excellent clinical results.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Management of Benign Dynamic “A-Shape” Tracheal Stenosis: A Retrospective Study of 60 Patients

Plojoux¹,

Laroumagne²,

Vandemoortele

et al. 2015

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Background. Benign tracheal stenosis complicates tracheal intubation or tracheostomy in 0.6% to 65% of cases. Surgical resection is the standard treatment. Endoscopic management is used for inoperable patients with 17% to 69% success. Dynamic "A-shape" tracheal stenosis (DATS) results in a dynamic stenosis with anterior fracture of tracheal cartilage and frequently associated posterior malacia. We report the results of our multidisciplinary management.Methods. Sixty patients with DATS were included. Management decision was made during initial bronchoscopy. When suitable, patients were referred to thoracic surgery for tracheal resection. Posterior localized tracheomalacia was treated with laser photocoagulation of the posterior tracheal wall. Tracheal stents were placed if the stenosis persisted after laser treatment. The choice of stent (straight silicone, hour-glass shaped silicone, Ttube, or fully-covered self-expandable metallic stent) was based on operator's judgment. After 12 to 18 months, stents were removed. If the stenosis persisted after stent removal, surgery was reconsidered. If surgery was not possible, a stent was replaced. In case of satisfactory

show abstract

Interventional endoscopy in the management of benign tracheal stenoses: definitive treatment at long-term follow-up

Cited by 152 publications

References 13 publications

Surgical Outcomes of Post Intubational or Post Tracheostomy Tracheal Stenosis: Report of 18 Cases in Single Institution

Surgical Outcomes of Post Intubational or Post Tracheostomy Tracheal Stenosis: Report of 18 Cases in Single Institution

The use of self-expandable metallic stents in the airways in the adult population

Management of Benign Dynamic “A-Shape” Tracheal Stenosis: A Retrospective Study of 60 Patients

Contact Info

Product

Resources

About