Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study.

Abstract

BACKGROUND:

Self-expandable metallic stents (SEMSs) have enabled a approving management of malignant airway stenosis. However, the long-term efficacy and safety of this treatment in patients with benign airway stricture are unclear. We conducted this study to retrospectively determine the efficacy and long-term outcomes in patients who have undergone SEMS placement for benign tracheobronchial stenosis.

METHODS:

All patients treated with SEMSs from July 2003 to June 2016 were reviewed for symptomatic response, complications, and long-term outcomes.

RESULTS:

Total 131 stents were successfully deployed in 116 patients. Ninety-eight patients demonstrated clinical improvement after stent insertion (84.48%; 95% confidence interval [CI]: 77.89-91.07). Compared with uncovered stents, covered stents were associated with more sore throats complaints or chest pain (13.89% versus 28.81%, P = 0.036) and with higher incidences of major and minor granulation tissue formation and with recurrent stenosis (4.17% versus 15.25%, P = 0.029; 11.11% versus 37.29%, P < 0.0001 and 9.72% versus 28.81%, P = 0.005, respectively). Each covered and uncovered stent developing tissue hyperplasia required a median of 2 (range: 1-15) and 1(range: 1-7) fibrobronchoscope with electrocautery therapy, respectively. At follow-up (median: 1276 days; range: 2-4263), 68 patients had complete resolution, 15 remained under interventional treatment, 8 had bronchial occlusions, 7 underwent surgery, 14 were lost to follow-up, and 4 died of stent unrelated causes.

CONCLUSION:

SEMS placement achieved most clinical improvement among patients in our study, if adequate endotracheal measures were used to address stent-related complications. The use of permanent SEMSs for benign tracheobronchial stenosis was effective and safe for the majority of patients in a long-term follow-up.

TRIAL REGISTRATION:

The study has been retrospectively registered in the China Clinical Trial Registry on October 21, 2018 (Registry ID: ChiCTR1800019024 ).

• Authors: Xiao-Feng Xiong, Li Xu, Li-Li Fan, De-Yun Cheng, Bi-Xia Zheng
• Journal: BMC pulmonary medicine (BMC Pulm Med) Vol. 19 Issue 1 Pg. 33 (Feb 08 2019) ISSN: 1471-2466 [Electronic] England
• PMID: 30736856 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Airway Obstruction (etiology, surgery)
• Bronchial Diseases (etiology, surgery)
• Bronchoscopy
• China
• Constriction, Pathologic (etiology, surgery)
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Prosthesis Design
• Reproducibility of Results
• Retrospective Studies
• Self Expandable Metallic Stents
• Tracheal Stenosis (etiology, surgery)
• Treatment Outcome
• Young Adult