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Use of silicone stents for the management of post-tuberculosis tracheobronchial stenosis

¹ Division of Pulmonary and Critical Care Medicine, Dept of Internal Medicine, Dongdaemun Hospital, Ewha Womans University, College of Medicine, and ² Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

CORRESPONDENCE: H. Kim, Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea. Fax: 822 34103849. E-mail: hjkim{at}smc.samsung.co.kr

Keywords: Airway stenoses, bronchoscopy, intervention, tuberculosis

Received: February 10, 2006
Accepted August 16, 2006

The role of bronchoscopic management in post-tuberculosis tracheobronchial stenosis is not well defined. To investigate the role of bronchoscopic intervention, including silicone stenting, in the management of post-tuberculosis tracheobronchial stenosis, the current retrospective study was conducted at a tertiary referral hospital.

Under rigid bronchoscopy, 80 patients underwent ballooning, neodymium-yttrium aluminium garnet laser resection and/or bougienation as first-line methods of airway dilatation between January 2000 and December 2003 inclusive, and were followed for a median of 41 months.

Silicone stents were required in 75 out of 80 (94%) patients to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in 88% of the patients. After airway stabilisation, stents were removed successfully in 49 out of 75 (65%) patients at a median of 14 months post-insertion. Three patients out of 75 (4%) eventually underwent surgical management. Acute complications included: excessive bleeding (n = 1); pneumothorax (n = 5); and pneumomediastinum without mortality (n = 2). Stent-related late complications, such as migration (51%), granuloma formation (49%), mucostasis (19%) and re-stenosis (40%), were controllable during a median follow-up of 41 months.

In conclusion, bronchoscopic intervention, including silicone stenting, could be a useful and safe method for treating post-tuberculosis tracheobronchial stenosis.

This article has been cited by other articles:

				S. D. Murgu and H. G. Colt Complications of Silicone Stent Insertion in Patients With Expiratory Central Airway Collapse Ann. Thorac. Surg., December 1, 2007; 84(6): 1870 - 1877. [Abstract] [Full Text] [PDF]