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Decannulation in Tracheal Stenosis Deemed Inoperable Is Possible After Long-Term Airway Stenting.
MedLine Citation:
PMID:  23201102     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Decannulation is the ultimate therapeutic goal for patients who undergo stenting because of inoperable benign tracheal stenosis. In this study, our objectives were to evaluate whether long-term airway stenting allows decannulation in patients with benign tracheal stenosis who were deemed inoperable and to identify possible predictive factors for successful decannulation (SD). METHODS: Retrospective cohort study including all patients with inoperable benign tracheal stenosis who underwent tracheal stenting in our tertiary-care university-based institution from 1998 to 2008. For benign stenosis, we use only silicone stents (T tubes, Dumon stents, and Y stents). The main outcome was SD, which was defined as removal of the tracheal stent followed by absence of respiratory symptoms and no requirement for new dilation procedures for at least 6 months. A Kaplan-Meier curve was built to evaluate SD in 5 years, and we used a Cox model to evaluate predictors for a SD. RESULTS: Ninety-two patients were included, and during the study period 21 were decannulated. However, 2 of them had to undergo new airway procedures and were considered to represent failure. Therefore, 19 patients were successfully decannulated. According to the Kaplan-Meier estimate, the SD rate in 5 years was 27.5%. The mean follow-up time after SD was 34.3 ± 33.9 months (range, 6 to 108 months). Cox regression showed only 1 significant factor: tracheostomy before stent insertion caused a threefold increase in the likelihood of the patient remaining with a tracheal stent (p = 0.048). CONCLUSIONS: Tracheal stenting may be considered a curative therapeutic approach in as many as 27.5% of patients with inoperable benign tracheal stenosis.
Authors:
Ricardo Mingarini Terra; Benoit Jacques Bibas; Helio Minamoto; Daniel Reis Waisberg; Mauro Federico Luis Tamagno; Miguel Lia Tedde; Paulo Manuel Pêgo-Fernandes; Fabio Biscegli Jatene
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Thoracic Surgery Department, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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