Endoscopic Treatment of Central Airway Stenosis: Five Years' Experience

• Published in: Archivos de bronconeumología (English ed.) 2005-06, Vol.41 (6), p.322-327
• Main Authors: Cosano Povedano, A., Muñoz Cabrera, L., Cosano Povedano, F.J., Rubio Sánchez, J., Pascual Martínez, N., Escribano Dueñas, A.
• Format: Article
• Language: English
• Subjects: Airways; Broncoscopia intervencionista; Interventional bronchoscopy; Prótesis; Stents; Vías aéreas
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/S1579-2129(06)60231-0

TO describe our experience with interventional bronchoscopy in the treatment of central airway stenosis. We reviewed patient records and bronchoscopic findings. Clinical data, findings from computed tomography, techniques performed, complications, and results were recorded. One-hundred and thirty-six patients (90 males and 46 females) were treated. The mean (SD) age was 57 (7) years (range, 3-81). A total of 320 therapeutic interventions were performed: 145 laser treatments, 33 balloon or mechanical dilatations, 26 electrocauterizations, and 116 stent insertions. Pathogenesis varied: in 64 (47%) patients, the stenosis was caused by a tumor (48 were bronchopulmonary and 16 nonpulmonary); in 72 (53%) patients, stenosis was secondary to a nontumor-related process, of which the most common was prolonged intubation (42% of these cases). Central airway patency was achieved in 92% (59/64) of the tumor-related stenoses and 96% (69/72) of those unrelated to tumors. Improvement in dyspnea was observed in 96% of all patients. Two deaths (due to hemoptysis and to acute myocardial infarction) occurred in the first week, for a 1.4% mortality rate. The most common complications were stent migration (8%; 9/116 cases) and the formation of granulomas (9%; 11/116). Interventional bronchoscopy is an effective technique to resolve life-threatening obstructions of the central airways. Dyspnea improves immediately and there is no significant morbidity or mortality. Describir nuestra experiencia en estenosis de la vía aérea principal (VAP) tratadas mediante broncoscopia intervencionista. Se han revisado las historias clíni-cas e informes de broncoscopia y se han registrado los datos clínicos, informe de tomografía axial computarizada, técnicas realizadas, complicaciones y resultados. Se trató a 136 pacientes (90 varones y 46 mujeres), con una edad media ± desviación estándar de 57 ± 7 años (rango: 3-81), en quienes se realizaron 320 procedimientos terapéuticos, que incluyeron 145 tratamientos con láser, 33 dilataciones con balón o mecánicas, 26 tratamientos mediante electrocauterio y la colocación de 116 prótesis. La etiología de la estenosis fue diversa: hubo 64 (47%) de causa tumoral (48 de origen broncopulmonar y 16 tumores extrapulmonares), mientras que en 72 pacientes (53%) la estenosis fue secundaria a una enfermedad no tumoral; de éstas, la causada por intubación prolongada fue la más frecuente (el 42% de los casos). La permeabilidad de la VAP se logró en el 92% (59/64) de