Silicone Stents in the Management of Inoperable Tracheobronchial Stenoses – Results (2)

Tolerance of Stents
The tolerance of the stents was excellent in 27 patients (87 percent). The postoperative complications are listed in Table 2. The only intraoperative complication was a short fire to an indwelling prosthesis on a subsequent laser therapy session, which could be extinguished with saline solution; the prosthesis was left in place. One very high tracheal stent (proximal end < 1 cm below the vocal cords) had to be removed due to otalgia and dysphagia necessitating a tracheostomy. One lethal complication occurred in a patient 4 months after stent placement in the right main bronchus. He was readmitted to the hospital because of slight hemoptysis, and fiberoptic bronchoscopy revealed a totally obstructed intermediate bronchus due to tumor recurrence distal to the stent. The stent was removed and repeated laser therapy was performed.

A few hours after the procedure, a lethal hemoptysis occurred. In two patients, bronchial stents were temporarily obstructed by mucus, which was successfully removed by fiberoptic suction. The most frequent complication was migration which occurred with five stents in three patients. The stents were of adequate size and length. All three patients initially presented with short (<2.5 cm axial length) and conical stenoses and in two of three the stenosis was caused by pure extrinsic compression of the airway with an intact mucosa. Migration led to cough and severe dyspnea necessitating the immediate removal of the stents.

Table 2—Endoscopic Palliation for Tracheobronchial Stenoses (n = 31): Stent-Related Complications

Complications Stents (n)
Migration 5
Mucus obstruction 2
Intolerance 1
Stent fire 1
Hemoptysis 1
Total 10