A novel designed V-shaped silicone stent for the treatment of unilateral main bronchial stenosis V-shaped stent for bronchial stenosis

Background and aims: Post-tuberculosis bronchial stenosis (PTBS) is one of the most common complications of tracheobronchial tuberculosis. Silicone stent serves as a major treatment for maintaining airway patency. However, silicone stent placement remains a large challenge in patients with severe cicatricial PTBS. Our objective was to evaluate the efficacy and safety of covered, self-expanding, metallic stents (SEMSs) as a transition to silicone stent implantation for treating severe PTBS. Methods: We retrospectively reviewed the data of patients with severe PTBS who received airway stenting in the First Affiliated Hospital of Guangdong Medical University between September 2015 and May 2019. The types of the stent, intervention procedures, bronchoscopic findings, clinical outcomes and related complications were collected and analyzed. Results: Fifty-eight cases with severe PTBS were included in this study. Thirteen (22.4%) of the patients received bronchial silicone stent implantation immediately after dilations. For the remaining 45 (77.6%) patients, silicone stents could not be deployed after dilations and SEMSs implantation was implemented as a bridge to silicone stenting. The SEMSs were placed for an interval of 28.4 ± 11.1 days. All of the silicone stents were inserted successfully following the removal of SEMSs. No SEMS-related complication occurred. The subgroup analysis showed that patients who received transitional SEMSs had less luminal caliber but fewer transbronchial dilations before silicone stent implantation ( p < 0.05). Conclusion: Covered SEMS placement as a transition to silicone stenting could serve as a feasible procedure to reduce complications and improve the success rate of silicone stent implantation in patients with severe PTBS. The reviews of this paper are available via the supplemental material section.

Download Full-text

Timing of silicone stent removal in patients with post-tuberculosis bronchial stenosis

Annals of Thoracic Medicine ◽

10.4103/1817-1737.118504 ◽

2013 ◽

Vol 8 (4) ◽

pp. 218 ◽

Cited By ~ 7

Author(s):

Hojoong Kim ◽

HyeYun Park ◽

Kyeongman Jeon ◽

Sang-Won Um ◽

Won Jung Koh ◽

...

Keyword(s):

Bronchial Stenosis ◽

Stent Removal ◽

Silicone Stent

Download Full-text

Bronchial stenosis treatment after lung transplantation with a self-expandable silicone stent

Clinics ◽

10.1590/s1807-59322007000500019 ◽

2007 ◽

Vol 62 (5) ◽

pp. 643-644 ◽

Cited By ~ 3

Author(s):

Marcos Naoyuki Samano ◽

Hélio Minamoto ◽

Eduardo Quintino de Oliveira ◽

Marlova Luzzi Caramori ◽

Paulo Manuel Pêgo-Fernandes ◽

...

Keyword(s):

Lung Transplantation ◽

Bronchial Stenosis ◽

Silicone Stent

Download Full-text

Respiratory Dynamic CT: Functional Evaluation of Main Bronchial Stenosis

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1996.35.4.473 ◽

1996 ◽

Vol 35 (4) ◽

pp. 473

Author(s):

Myung Jin Chung ◽

Jung Gi Im ◽

Kyung Mo Yeon

Keyword(s):

Functional Evaluation ◽

Dynamic Ct ◽

Bronchial Stenosis

Download Full-text

Tuberculosis as a Re-emerging Infectious Disease. Diagnosis and Treatment for Thacheal and Bronchial Tuberculosis: Surgical Treatment of Tracheal and Bronchial Stenosis Following Tracheal and Bronchial Tuberculosis.

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.52.387 ◽

2001 ◽

Vol 52 (5) ◽

pp. 387-394 ◽

Cited By ~ 1

Author(s):

Keizo Inagaki

Keyword(s):

Infectious Disease ◽

Surgical Treatment ◽

Disease Diagnosis ◽

Emerging Infectious Disease ◽

Diagnosis And Treatment ◽

Bronchial Stenosis

Download Full-text

Use of an Insulation-Tipped Knife during Rigid Bronchoscopic Treatment of Benign Tracheobronchial Stenosis

Medicina ◽

10.3390/medicina57030251 ◽

2021 ◽

Vol 57 (3) ◽

pp. 251

Author(s):

Ji-Won Park ◽

Yousang Ko ◽

Changhwan Kim

Keyword(s):

Tracheal Stenosis ◽

Treatment Success ◽

Stable State ◽

Forced Expiratory Volume ◽

Rigid Bronchoscopy ◽

Bronchial Stenosis ◽

Tracheobronchial Stenosis ◽

Acute Complications ◽

The Mean ◽

Post Intubation

Background and Objectives: Tracheal or bronchial tears are potential complications of rigid bronchoscopy. This study aimed to investigate the acute complications and outcomes of using an insulation-tipped (IT) knife in combination with rigid bronchoscopic dilatation for treating benign tracheobronchial stenosis. Materials and Methods: We conducted a chart review of patients with benign tracheobronchial stenosis who were treated with rigid bronchoscopy and an IT knife at two referral centers. Treatment success was defined as a clinically stable state without worsening symptoms after 3 months of treatment. Results: Of the 23 patients with benign tracheobronchial stenosis, 15 had tracheal stenosis and 6 had main bronchial stenosis. Among them, three cases were of simple stenosis (13%), while the others were of complex stenosis (87%). The overall treatment success rate was 87.0%. Pneumomediastinum and subcutaneous emphysema occurred due to bronchial laceration in two cases of distal left main bronchial stenosis (8.7%), and no other significant acute complications developed. Silicone stents were inserted in 20 patients, and successful stent removal was possible in 11 patients (55.0%). Six of the seven stents inserted in patients with post-intubation tracheal stenosis were removed successfully (85.7%). However, most of the patients with post-tracheostomy tracheal stenosis required persistent stenting (80%). Pulmonary function was significantly increased after treatment, and the mean increase in the forced expiratory volume in 1 s was 391 ± 171 mL (160–700 mL). Conclusion: The use of an IT knife can be suggested as an effective and safe modality for rigid bronchoscopic treatment of benign tracheobronchial stenosis.

Download Full-text

Lung autotransplantation for bronchial necrosis after radiotherapy: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01164-0 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yuya Nobori ◽

Masaaki Sato ◽

Mizuki Morota ◽

Yoshikazu Shinohara ◽

Daisuke Yoshida ◽

...

Keyword(s):

Radiation Therapy ◽

Pulmonary Function ◽

Treatment Success ◽

Locally Advanced ◽

Fistula Formation ◽

Bronchial Anastomosis ◽

Silicone Stent ◽

Feasible Option ◽

Malignant Germ Cell Tumor ◽

The Right

Abstract Background Bronchial necrosis is a rare but fatal complication after radiation therapy. Because of the anatomical complexity and rarity of this condition, determining the most appropriate management for individual patients is extremely challenging. Lung autotransplantation is a surgical technique that has been applied to hilar neoplastic lesions to preserve pulmonary function and avoid pneumonectomy. We herein report a case of bronchial necrosis secondary to radiotherapy that was treated with lung autotransplantation. Case presentation A 46-year-old man developed broad necrosis and infection of the right bronchus secondary to previous stereotactic body-radiation therapy. This treatment was supplied close to a right hilar metastatic pulmonary tumor derived from a mediastinal malignant germ cell tumor that had been surgically resected with the left phrenic nerve. The bronchial necrosis accompanied by infection with Aspergillus fumigatus was progressive despite antibiotics and repetitive bronchoscopic debridement. Because of the patient’s critical condition and limited pulmonary function, right lung autotransplantation with preservation of the right basal segment was selected. An omental flap was placed around the bronchial anastomosis to prevent later complications. The postoperative course involved multiple complications including contralateral pneumonia and delayed wound healing at the bronchial anastomosis with resultant stenosis, the latter of which was overcome by placement of a silicone stent. The patient was discharged 5 months postoperatively. Three months after discharge, however, the patient developed hemoptysis and died of bronchopulmonary arterial fistula formation. Conclusions We experienced an extremely challenging case of bronchial necrosis secondary to radiotherapy. The condition was managed with lung autotransplantation and omental wrapping; however, the treatment success was temporary and the patient eventually died of bronchopulmonary arterial fistula formation. This technique seems to be a feasible option for locally advanced refractory bronchial necrosis, although later complications can still be fatal.

Download Full-text

Laryngeal stent for acute and chronic respiratory distress in seven dogs with laryngeal paralysis

Open Veterinary Journal ◽

10.4314/ovj.v10i1.2 ◽

2020 ◽

Vol 10 (1) ◽

pp. 4-10 ◽

Cited By ~ 1

Author(s):

María Cecilia Ricart ◽

Sergio Martín Rodríguez ◽

Roberto Miguel Duré

Keyword(s):

Respiratory Distress ◽

Alternative Therapy ◽

Clinical Signs ◽

Surgical Techniques ◽

Case Series ◽

Laryngeal Function ◽

Laryngeal Stenosis ◽

Laryngeal Paralysis ◽

Silicone Stent

Background: Laryngeal paralysis, failure of arytenoid cartilage, and vocal fold abduction are commonly seen in older medium to large breed dogs. Observation of laryngeal function in dogs and cats is performed by transoral visualization. There are a variety of surgical techniques; aspiration pneumonia is the most common complication associated with surgical correction of laryngeal paralysis. The aim of this case series is to report on the placement of a laryngeal silicone stent in seven dogs with laryngeal paralysis and its use as an alternative treatment of respiratory distress caused by laryngeal paralysis and/or its use for laryngeal stenosis as complication of laryngeal paralysis surgery.Case description: Seven dogs presented with either episode of gagging, mild-to-severe inspiratory distress, or cyanosis because of a laryngeal paralysis or laryngeal stenosis. In each case, the laryngeal paralysis was diagnosed by direct laryngoscopy. They were treated with a silicone laryngeal stent (Stening®) that substantially improved the clinical signs. Each dog had a different outcome because of other pathologies; however, the laryngeal pathology was successfully treated with the stent.Conclusion: The placement of the laryngeal stent is an easy technique to learn and practice, it could avoid the lifethreatening complications of the laryngeal paralysis at the acute phase, and it could be a noninvasive and long-term alternative therapy for laryngeal paralysis in dogs. The results in these clinical cases are encouraging for considering the laryngeal stent as a therapeutic alternative. Key words: Canine, Polyneuropathy, Prosthesis, Surgery.

Download Full-text