Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Xiong, Xiao-feng, Xu, Li, Fan, Li-li, Cheng, De-yun, Zheng, Bi-xia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
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
_version_ 1783394045611999232
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
work_keys_str_mv AT xiongxiaofeng longtermfollowupofselfexpandablemetallicstentsinbenigntracheobronchialstenosisaretrospectivestudy
AT xuli longtermfollowupofselfexpandablemetallicstentsinbenigntracheobronchialstenosisaretrospectivestudy
AT fanlili longtermfollowupofselfexpandablemetallicstentsinbenigntracheobronchialstenosisaretrospectivestudy
AT chengdeyun longtermfollowupofselfexpandablemetallicstentsinbenigntracheobronchialstenosisaretrospectivestudy
AT zhengbixia longtermfollowupofselfexpandablemetallicstentsinbenigntracheobronchialstenosisaretrospectivestudy