HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Puma, F. Articles by Daddi, G. Search for Related Content PubMed PubMed Citation Articles by Puma, F. Articles by Daddi, G.

J Thorac Cardiovasc Surg 2000;120:1064-1069
© 2000 The American Association for Thoracic Surgery

General Thoracic Surgery

The role of silicone stents in the treatment of cicatricial tracheal stenoses

From the Clinica Chirurgica Generale e Toracica, University of Perugia Medical School, Ospedale Civile di Terni, Terni, Italy.

Address for reprints: Francesco Puma, MD, Clinica Chirurgica Generale e Toracica, Ospedale Civile di Terni, 05100 Terni, Italy.

Objective: Tracheal stenting for cicatricial stenoses is reserved for patients whose lesions are deemed inoperable for local or general reasons. The aim of our study was to verify the long-term results of silicone tracheal stents in such a clinical setting.
Methods: Clinical data of 45 patients treated by tracheal silicone stents, between 1987 and 1999, were reviewed. All patients had highly symptomatic cicatricial stenoses; they were selected for stenting rather than for surgery because of local and general conditions. This series has been divided in two groups according to the purpose of stenting: bridge to surgery or definitive treatment. Follow-up ranged between 12 and 83 months. Twenty-seven patients received a Montgomery T tube (Hood Laboratories, Pembroke, Mass), 16 a Dumon stent (Novatech, Plan de Gras, France), and 2 a Dynamic stent (Rusch, Kernen, Germany).
Results: No procedure-related mortality was observed. Nine patients underwent curative resection and reconstruction after a variable stenting period; one had a recurrent stenosis and was treated for palliation with a T tube. Tracheal stenting was performed for palliation as a definitive treatment in 37 patients. Among this group, 11 patients died of unrelated causes at a median of 10 months after the endoscopic treatment. The stent was permanently removed in 10 after a median interval of 32 months (range 9-70 months); in 4 others, symptomatic recurrence of the stenosis was observed within 6 weeks of stent removal. None of the patients successfully decannulated had a completely normal tracheal lumen but all remained asymptomatic because the residual stenosis was mild or well tolerated for concomitant limitation of physical activity.
Conclusions: Long-term treatment with a silicone stent was safe and well tolerated in cicatricial tracheal stenoses. This procedure can be considered as a bridge to curative surgery or as a definitive treatment. The latter, generally performed for palliation, may provide satisfactory therapeutic results in selected patients, even in the presence of severe circumferential stenoses.

This article has been cited by other articles:

				S. Bahrami, D. Chow, and B. Kadell Thoracic and Abdominal Devices Radiologists Should Recognize: Pictorial Review Am. J. Roentgenol., December 1, 2009; 193(6_Supplement): S106 - S118. [Abstract] [Full Text] [PDF]

				F. Puma and M. Ragusa Technical Standpoints in Tracheal Surgery Ann. Thorac. Surg., April 1, 2008; 85(4): 1500 - 1500. [Full Text] [PDF]

				A. Abbasidezfouli Reply Ann. Thorac. Surg., April 1, 2008; 85(4): 1500 - 1501. [Full Text] [PDF]

				A. M. Rampey, G. A. Silvestri, and M. B. Gillespie Combined Endoscopic and Open Approach to the Removal of Expandable Metallic Tracheal Stents Arch Otolaryngol Head Neck Surg, January 1, 2007; 133(1): 37 - 41. [Abstract] [Full Text] [PDF]

				Y. J. Ryu, H. Kim, C. M. Yu, J. C. Choi, Y. S. Kwon, and O. J. Kwon Use of silicone stents for the management of post-tuberculosis tracheobronchial stenosis Eur. Respir. J., November 1, 2006; 28(5): 1029 - 1035. [Abstract] [Full Text] [PDF]

				C. T. Bolliger, T. G. Sutedja, J. Strausz, and L. Freitag Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur. Respir. J., June 1, 2006; 27(6): 1258 - 1271. [Abstract] [Full Text] [PDF]

				C.-Y. Wu, Y.-H. Liu, M.-J. Hsieh, and P.-J. Ko Use of the Montgomery T tube in ventilator-dependent patients Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 122 - 124. [Abstract] [Full Text] [PDF]