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Eur J Cardiothorac Surg. 2014 Apr;45(4):e100-9. doi: 10.1093/ejcts/ezt626. Epub 2014 Jan 19.

Tracheobronchial obstruction: follow-up study of 100 children treated with airway stenting.

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1
Respiratory Endoscopy Unit, Department of Paediatric Anesthesia and Intensive Care, Meyer Children Hospital, Florence, Italy.

Abstract

OBJECTIVE:

We described a cohort of 100 children with a wide variety of airway obstruction who underwent stent positioning in the last 7 years. The study examined the outcomes of this treatment in the largest series of paediatric patients reported in the literature with special concern over safety and clinical effectiveness.

METHODS:

We performed a retrospective analysis of 100 consecutive paediatric patients who underwent stent insertions between January 2005 and May 2012. Statistical analysis was performed and exact likelihood was used.

RESULTS:

A total of 235 stents were placed for severe airway obstruction. One hundred and twelve silicone stents (cylinder, hourglass or Y-shaped), 120 metallic stents (covered Nitinol stents, expandable coronary and vascular stents) and 3 biodegradable polydioxanone (PDS) stents were used. Eighty patients presented clinical improvement after stent insertion, 17 were weaned off mechanical ventilation and 3 showed no significant clinical improvement [95% confidence interval (CI) 0.1-8.0%]. Complications were different according to stent type. In our cohort, no fatal stent-related complications have been observed. At follow-up (median 41.4 months, range 1.1-145.4) complete resolution was registered for 60 patients (66%; 95% CI 55-76%), 17 are still under treatment, 9 were lost to follow-up, 8 underwent surgery and 6 died of causes not stent related.

CONCLUSION:

Airway stenting represents a conservative treatment before more invasive surgical procedures and can be very effective when performed in selected children and in specialized centres by physicians experienced in rigid and flexible bronchoscopy.

KEYWORDS:

Airway stent; Cohort study; Metallic stent; Self-expandable stent; Silicone stent; Tracheobronchomalacia; Tracheobronchostenosis

PMID:
24446473
DOI:
10.1093/ejcts/ezt626
[Indexed for MEDLINE]
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