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Efficacy and Tolerance of a New Silicone Stent for the Treatment of Benign Tracheal Stenosis^*

Preliminary Results

^* From the Department of Chest Diseases and Thoracic Oncology (Dr. Vergnon), and Department of Physiology (Dr. Costes), GIP Exercice, Hôpital Nord, University Hospitals of Saint Etienne, France; and Department of Chest Diseases (Dr. Polio), Hôpital Saint Jacques, University Hospitals of Besançon, France.

Correspondence to: Jean-Michel Vergnon, MD, Department of Chest Diseases and Thoracic Oncology, Hôpital Nord, Chu de Saint-Etienne, 42055 Saint-Etienne cedex 2, France; e-mail: vergnon{at}univ-st-etienne.fr

Study objective: In inoperable patients with tracheal stenosis who are treated using silicone stents, stent migration occurs in 18.6% of cases. To decrease the migration rate, we have designed a new silicone stent with narrow central and larger distal parts. This study analyzes the stability and tolerance of this new stent.

Design: Preliminary prospective study conducted in two French university hospitals.

Patients: Thirteen inoperable patients with benign complex tracheal stenosis due to intubation or tracheotomy.

Interventions: Tracheal stent insertion was performed under general anesthesia with a rigid bronchoscope. The patients were followed up clinically up to stent removal, which was planned at 18 months.

Results: Stent insertion or removal was very simple and did not differ from other silicone stents. No migration occurred after a mean follow-up of 22.8 months. Minimal granuloma formation occurred in only one patient (7.7%). Sputum retention remained similar to that with other silicone stents and could be improved by a smoother internal wall. Stents have been removed in seven patients after a mean duration of 19.6 months, with a complete stenosis cure in four cases.

Conclusion: This new stent combines the excellent stability of the metallic stents and the tolerance and easy removal of straight silicone stents. This allows a prolonged use in order to obtain curative action.

Key Words: complex tracheal stenosis • silicone stents • stents • therapeutic bronchoscopy

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