Endoscopic treatment of central airway stenosis: five years' experience

• Published in: Archivos de bronconeumología 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: Spanish
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Airway Obstruction - diagnosis; Airway Obstruction - drug therapy; Airway Obstruction - surgery; Airway Obstruction - therapy; Bronchial Diseases - etiology; Bronchial Neoplasms - complications; Bronchial Neoplasms - surgery; Bronchoscopes; Bronchoscopy - statistics & numerical data; Catheterization - methods; Catheterization - statistics & numerical data; Child; Child, Preschool; Dyspnea - etiology; Dyspnea - surgery; Electrocoagulation - methods; Electrocoagulation - statistics & numerical data; Female; Foreign-Body Migration - etiology; Granuloma - etiology; Hemoptysis - mortality; Humans; Intraoperative Complications - epidemiology; Intubation, Intratracheal - adverse effects; Laser Therapy - methods; Laser Therapy - statistics & numerical data; Lung Neoplasms - complications; Lung Neoplasms - surgery; Male; Middle Aged; Myocardial Infarction - mortality; Postoperative Complications - mortality; Retrospective Studies; Stents; Tracheal Neoplasms - complications; Tracheal Neoplasms - surgery; Treatment Outcome; Vocal Cords - injuries
• ISSN: 0300-2896
• DOI: 10.1157/13076000

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.