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Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study
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 a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368722/ https://www.ncbi.nlm.nih.gov/pubmed/30736856 http://dx.doi.org/10.1186/s12890-019-0793-y |
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author | Xiong, Xiao-feng Xu, Li Fan, Li-li Cheng, De-yun Zheng, Bi-xia |
author_facet | Xiong, Xiao-feng Xu, Li Fan, Li-li Cheng, De-yun Zheng, Bi-xia |
author_sort | Xiong, Xiao-feng |
collection | PubMed |
description | 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). |
format | Online Article Text |
id | pubmed-6368722 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63687222019-02-15 Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study Xiong, Xiao-feng Xu, Li Fan, Li-li Cheng, De-yun Zheng, Bi-xia BMC Pulm Med Research Article 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). BioMed Central 2019-02-08 /pmc/articles/PMC6368722/ /pubmed/30736856 http://dx.doi.org/10.1186/s12890-019-0793-y Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Xiong, Xiao-feng Xu, Li Fan, Li-li Cheng, De-yun Zheng, Bi-xia Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
title | Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
title_full | Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
title_fullStr | Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
title_full_unstemmed | Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
title_short | Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
title_sort | long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: a retrospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6368722/ https://www.ncbi.nlm.nih.gov/pubmed/30736856 http://dx.doi.org/10.1186/s12890-019-0793-y |
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