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Expandable metal stents as an alternative treatment of cuff-related tracheal stenosis in tracheostomy-dependent ventilated patients: a prospective study of nine cases and description of the complications

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Abstract

Background and aims

In long-term intubated patients, cuff-related tracheal injury is occasionally complicated by tracheal stricture. To keep the airway patent, bougienage and deployment of stents are adopted in patients unfit for surgery.

Materials and methods

Prospectively, nine episodes of cuff-related tracheal stricture in nine tracheostomy-dependent ventilated patients were treated with pre-stenting bougienage, followed by implantation of expandable metal stents (EMS). The primary endpoint of this study was the successful discharge of the patients back to the chronic care unit. The other endpoint was the re-treatment rate.

Results

The mean age of the nine patients was 61.7 years. The follow-up period was 18.6 months. The first two patients received a bare stent, and the other seven patients received membrane-coated stents. They all recovered well with successful discharge back to the chronic care unit. There were two episodes of granulation formation in one bare-stent patient and in one coated-stent patient, respectively. In another coated-stent patient, complications arose from a broken stent.

Conclusion

EMS appears to have a role to play in tracheostomy-dependent ventilated patients with benign tracheal stenoses in whom there are no other reasonable options.

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References

  1. Maddaus MA, Toth JL, Gullane PJ, Pearson FG (1992) Subglottic tracheal resection and synchronous laryngeal reconstruction. J Thorac Cardiovasc Surg 104:1443–1450

    PubMed  CAS  Google Scholar 

  2. Grillo HC (1979) Surgical treatment of postintubation tracheal injuries. J Thorac Cardiovasc Surg 78:860–875

    PubMed  CAS  Google Scholar 

  3. Spittle N, McCluskey A (2000) Lesson of the week: tracheal stenosis after intubation (see comment). BMJ 321:1000–1002

    Article  PubMed  CAS  Google Scholar 

  4. Madden BP, Stamenkovic SA, Mitchell P (2000) Covered expandable tracheal stents in the management of benign tracheal granulation tissue formation (see comment). Ann Thorac Surg 70:1191–1193

    Article  PubMed  CAS  Google Scholar 

  5. Wood DE, Liu YH, Vallieres E, Karmy-Jones R, Mulligan MS (2003) Airway stenting for malignant and benign tracheobronchial stenosis. Ann Thorac Surg 76:167–172, discussion 173–174

    Article  PubMed  Google Scholar 

  6. Yukihito S, Hiroji I (2005) Airway stenting. Surg Today 35:265

    Article  Google Scholar 

  7. Pearson FG, Andrews MJ (1971) Detection and management of tracheal stenosis following cuffed tube tracheostomy. Ann Thorac Surg 12:359–374

    Article  PubMed  CAS  Google Scholar 

  8. Grillo HC, Donahue DM, Mathisen DJ, Wain JC, Wright CD (1995) Postintubation tracheal stenosis. Treatment and results. J Thorac Cardiovasc Surg 109:486–493

    Article  PubMed  CAS  Google Scholar 

  9. Stauffer JL, Olson DE, Petty TL (1981) Complications and consequences of endotracheal intubation and tracheostomy. A prospective study of 150 critically ill adult patients. Am J Med 70:65–76

    Article  PubMed  CAS  Google Scholar 

  10. Noppen M, Schlesser M, Meysman M, D’Haese J, Peche R, Vincken W (1997) Bronchoscopic balloon dilatation in the combined management of postintubation stenosis of the trachea in adults. Chest 112:1136–1140

    PubMed  CAS  Google Scholar 

  11. Montgomery WW (1974) Silicone tracheal T-tube. Ann Otol Rhinol Laryngol 83:71–75

    PubMed  CAS  Google Scholar 

  12. Gaissert HA, Grillo HC, Wright CD, Donahue DM, Wain JC, Mathisen DJ (2003) Complication of benign tracheobronchial strictures by self-expanding metal stents. J Thorac Cardiovasc Surg 126:744–747

    Article  PubMed  Google Scholar 

  13. Saad CP, Murthy S, Krizmanich G, Mehta AC (2003) Self-expandable metallic airway stents and flexible bronchoscopy: long-term outcomes analysis. Chest 124:1993–1999

    Article  PubMed  Google Scholar 

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Correspondence to Yu-Jen Cheng.

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Cheng, YJ., Kao, EL. Expandable metal stents as an alternative treatment of cuff-related tracheal stenosis in tracheostomy-dependent ventilated patients: a prospective study of nine cases and description of the complications. Langenbecks Arch Surg 392, 479–483 (2007). https://doi.org/10.1007/s00423-006-0110-0

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  • DOI: https://doi.org/10.1007/s00423-006-0110-0

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