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

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

^* To whom correspondence should be addressed. E-mail: hjkim{at}smc.samsung.co.kr.

	Abstract

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, this retrospective review was conducted at a tertiary referral hospital.

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

Silicone stents were required in 75/80 (94%) patients to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in 88% of the patients. After airway stabilization, stents were removed successfully in 65% (49/75) of the patients at a median 14 months post-insertion. Three patients (4%, 3/75) eventually underwent surgical management. Acute complications included; excessive bleeding in one patient, pneumothorax in 5, and pneumomediastinum in 2 without mortality. Stent-related late complications, such as, migration (51%), granuloma formation (49%), mucostasis (19%), and restenosis (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.

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