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

Abstract

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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Correspondence to Ashraf Madkour MD.

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Madkour, A., Elmansoury, A. & Elsharkawy, S. Interventional bronchoscopy in the initial management of benign and malignant tracheal stenoses. Egypt J Bronchol 9, 146–153 (2015). https://doi.org/10.4103/1687-8426.158049

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Keywords

  • Dumon stent
  • interventional bronchoscopy
  • tracheal stenosis