Modified silicone stent for the treatment of post-surgical bronchopleural fistula: a clinical observation of 17 cases

Zeng, Junli; Wu, Xuemei; Chen, Zhide; Zhang, Meihua; Ke, Mingyao

doi:10.1186/s12890-020-01372-8

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…However, these therapies do have some drawbacks. Managing TF currently remains challenging, and there are no viable techniques available [7,8]. Mesenchymal stem cells (MSCs) have recently been found to promote damaged tissue healing [9] and alleviate local inflammatory responses, giving patients a unique therapeutic alternative.…”

Section: Introductionmentioning

confidence: 99%

The therapeutic effect of stem cells from human exfoliated deciduous teeth on a rat model of tracheal fistula

Wang

Lyu

et al. 2022

Stem Cell Res Ther

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Background Tracheal fistulas (TF) can be dangerous and even fatal in patients. The current treatment is really challenging. Previous studies reported that mesenchymal stem cells (MSCs) could be used to treat respiratory tract fistulas. Stem cells from human exfoliated deciduous teeth (SHED) are considered to be MSC-like cells that may also have the potential to treat the tracheal fistulas. In this study, we investigated the therapeutic effects of SHED in rat tracheal fistula models. Methods A total of 80 SD rats were randomly divided into five groups: a sham-operated group, a local PBS group (L-PBS), an intravenous PBS group (I-PBS), a local SHED treatment group (L-SHED), and an intravenous SHED treatment group (I-SHED). The L-SHED and I-SHED groups were given a topical application around the fistula or an intravenous injection of 1*107 SHED via the tail vein, respectively, while the L-PBS and I-PBS groups were given an equivalent volume of PBS through local or intravenous administration. A stereomicroscope was used to observe fistula healing on the 2nd, 3rd, and 5th days following transplantation. On the 7th day, the survival of SHED was observed by immunofluorescence. The pathology of the lungs and fistulas was observed by hematoxylin and eosin (H&E) and Masson staining. The expression levels of the Toll-like receptor 4 (TLR4), interleukin (IL)-1β, IL-33, and IL-4 were measured using immunohistochemistry. The expression levels of TLR4, high mobility group box 1 (HMGB1), and myeloid differentiation factor 88 (MYD88) were studied using western blotting. On day 14, airway responsiveness of rats was detected and analyzed. Results Fistula healing in the L-SHED and I-SHED groups was faster than that in their respective PBS groups after transplantation. The fistula diameters in the L-SHED and I-SHED groups were significantly smaller than those in the L-PBS and I-PBS groups on the 3rd day. Moreover, the phenomenon of fibroblast proliferation and new blood vessel growth around the fistula seemed more pronounced in the L-SHED and I-SHED groups. Although no discernible difference was found in airway responsiveness after SHED treatment, the degree of inflammation in the lungs was reduced by intravenous SHED treatment. However, there was no significant reduction in lung inflammation by local SHED treatment. The expression levels of IL-1β and IL-33 were decreased in the I-SHED group, while IL-4 was elevated compared with the I-PBS group. Interestingly, intravenous SHED treatment inhibited the activation of HMGB1/TLR4/MYD88 in the lung tissues of TF rats. Conclusions SHED transplantation accelerated the rate of fistula healing in rats. Intravenous SHED treatment reduced lung inflammation. Thus, SHED may have potential in the treatment of tracheal fistula, providing hope for future therapeutic development for TF.

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Section: Introductionmentioning

confidence: 99%

The therapeutic effect of stem cells from human exfoliated deciduous teeth on a rat model of tracheal fistula

Wang

Lyu

et al. 2022

Stem Cell Res Ther

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“…Modified silicone or self-expandable metallic stents (SEMS) have been placed for BPF closure [40 ▪ ,41–44,45 ▪ ,46]. These modifications act to customize a stent to a patients’ unique airway following surgery or to have a sealed off limb to limit airflow through a BPF, allowing it to heal.…”

Section: Management Of Bronchopleural Fistulaementioning

confidence: 99%

An update on bronchopleural fistulae following cancer-related surgery

Bashour

Ost

2023

Current Opinion in Pulmonary Medicine

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Purpose of ReviewBronchopleural fistulae (BPF) are rare complications in cancer-related surgery but impart significant morbidity and mortality. BPF may be difficult to identify, with a broad differential diagnosis at presentation, so it is critical to be aware of newer diagnostic and therapeutic approaches for this disease entity.Recent FindingsMultiple novel diagnostic and therapeutic interventions are featured in this review. Reports of newer bronchoscopic techniques to localize BPF, as well as approaches for bronchoscopic management, like stent deployment, endobronchial valve placement, or alternative interventions when indicated are discussed, paying particular attention to factors that influence procedure selection.SummaryManagement of BPF remains highly variable, but several novel approaches have shown improved identification and outcomes. Although a multidisciplinary approach is imperative, an understanding of these newer techniques is important to provide optimal care for patients.

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“…Modifications may be as simple as shortening the length or punching a hole for side branch ventilation. More complex modifications like sewing different sizes, angles, or even closing off branches have been described [20][21][22][23]. A recent study, Guinde et al described a ten-year experience making bifurcated silicone stents sewing silicone stents into a Y-shape for the left secondary carina and a t-tube shape for the right.…”

Section: Silicone Stentsmentioning

confidence: 99%

Advancements in airway stents: a comprehensive update

Aravena,

Gildea

2023

Current Opinion in Pulmonary Medicine

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Purpose of review This review provides an overview of the evolving field of airway stenting (AS), highlighting its relevance in the management of central airway obstruction (CAO). It discusses recent advancements, including 3D-printed silicone stents (3DPSS), metallic stents, biodegradable stents (BS), and drug-eluting stents (DES), which are transforming clinical practice. The review underscores the ongoing challenges in patient selection, stent choice, and long-term management in the context of an evolving landscape. Recent findings Innovations, particularly 3DPSS, have shown promise in providing patient-specific solutions. These stents offer improved symptom relief, enhanced quality of life, and lower complication rates, especially for complex airway diseases. The use of BS and DES is explored, raising prospects for future applications. Summary The evolution of AS reflects a deepening understanding of airway obstructions. Recent innovations, such as 3DPSS, BS, and DES, show considerable promise in addressing the limitations of conventional stents. However, challenges related to complications, patient selection, and long-term management persist, demanding further research. Wide practice variations in the management of AS highlight the need for more clinical data and standardized guidelines. The search for the ideal stent continues, driven by the pursuit of better outcomes for patients with CAO.

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Modified silicone stent for the treatment of post-surgical bronchopleural fistula: a clinical observation of 17 cases

Cited by 7 publications

References 31 publications

The therapeutic effect of stem cells from human exfoliated deciduous teeth on a rat model of tracheal fistula

The therapeutic effect of stem cells from human exfoliated deciduous teeth on a rat model of tracheal fistula

An update on bronchopleural fistulae following cancer-related surgery

Advancements in airway stents: a comprehensive update

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