INTERVENTIONAL PULMONOLOGY IN OTHER JOURNALS: Commentary on Selected Publications
Endotracheal balloon dilatation and stent implantation in benign stenoses.
Schmidt B, Olze H, Borges AC, John M, Liebers U, Kaschke O, Haake K, Witt C. Ann Thorac Surg 2001;71:1630–4. Department of Internal Medicine I, Medical School of the Humboldt-University of Berlin, Germany.
This study investigated the outcome after balloon dilatation and silicone stent implantation in 42 patients with inoperable benign tracheal stenosis. In group A, 24 patients received tracheal stents as a temporary therapy, and in group B, 18 patients underwent stenting as a long-term measure because of severe concomitant medical conditions that did not allow for stent removal. Immediate results were satisfactory in all patients. In group A, stents could be removed in 12 patients after a mean interval of 20 months. Restenting was not required during the following 18.9 months. Twelve patients were still waiting for stent removal after a mean follow-up of 20 months. In group B, mean follow-up was 48.4 months. Complications included retained secretions, dislocation, and granuloma formation. The authors conclude that stenting after balloon dilatation is safe and effective in benign tracheal stenosis, and after temporary use, stents can be removed when local and general conditions permit. This report shows that silicone stents can be left in the tracheobronchial tree for prolonged periods with acceptable risks of secretions, dislocation, and granuloma formation. Balloon dilatation is more likely to help in effecting airway dilatation of benign stenosis, in contrast to malignant airway lesions, before insertion of silicone stents.