ORIGINAL ARTICLE
Year : 2015  |  Volume : 9  |  Issue : 2  |  Page : 146-153

Interventional bronchoscopy in the initial management of benign and malignant tracheal stenoses


Department of Pulmonary Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Ashraf Madkour
Department of Pulmonary Medicine, Faculty of Medicine, Ain Shams University, 1, Sabri Abu Alam St., Bab El-Louk, 11111 Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.158049

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Introduction: Management of tracheal stenoses is inconsistent. Interventional bronchoscopy (IB) is one of the therapeutic options used. Aim: The aim of the study was to investigate the role of IB in the initial management of tracheal stenosis, evaluating the treatment strategies used and complications encountered. Patients and methods: We prospectively recruited 30 patients presenting with bronchoscopically confirmed tracheal stenoses over 1 year. Twenty benign (six simple and 14 complex) and 10 inoperable malignant tracheal stenoses were studied. All except two patients underwent rigid IB with different modalities. Each patient was followed up for 6 months. Results: All simple, 12 complex (not eligible for surgery), and all malignant stenoses were treated with 17 (mean of 2.83 per patient), 52 (mean of 4.33 per patient), and 39 (mean of 2.83 per patient) IB procedures, respectively, including 1, 10, and 8 stent placements, respectively, with overall good therapeutic response after IB. Two patients with complex stenoses were sent for surgery. During the first 6 months after stent insertion, stent migration occurred in 27 and 12% and obstruction by mucus secretions occurred in 64 and 37% of benign and malignant stenoses, respectively. Granuloma formation occurred in 45% of benign stenoses. Tumor in-growth occurred in 37% of malignant stenoses. All complications were non-life-threatening stent-related complications that were easily managed. During follow-up, two malignant patients died of disease progression. Conclusion: IB is a useful option in the management of simple benign and inoperable complex benign and malignant tracheal stenoses associated with a relatively high rate of non-life-threatening stent-related complications that were easily managed.


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