Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (4): 549-554.doi: 10.3969/j.issn.2095-4344.2210

Previous Articles     Next Articles

Silicone stent insertion for treating tracheobronchomalacia in adults

Li Xiao, Pan Jinbing, Ma Yun, Qian Haoyu, Zhang Quncheng, Wang Zheng   

  1. Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou 450003, Henan Province, China
  • Received:2019-07-04 Revised:2019-07-06 Accepted:2019-07-31 Online:2020-02-08 Published:2019-12-31
  • Contact: Pan Jinbing, MD, Chief physician, Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou 450003, Henan Province, China
  • About author:Li Xiao, MD, Associate chief physician, Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou 450003, Henan Province, China
  • Supported by:
    Medical Science and Technology Research Project of Henan Province, No. 201504046

Abstract:

BACKGROUND: Silicone tracheobronchial stent insertion can provide symptomatic relief through airway stabilization in patients with symptomatic tracheobronchomalacia. However, there are few studies on this method.

OBJECTIVE: To evaluate the safety and efficacy of silicone stents in the treatment of tracheobronchomalacia.

METHODS: Eight tracheobronchomalacia patients who underwent silicone stent implantation at Henan Provincial People’s Hospital between September 2015 and December 2018 were included in this study. According to the location and degree of airway softening, appropriate silicone stents were designed. Silicone stents were implanted in all eight patients, including hourglass stents in 2 cases, straight tube stents in 2 patients, Y-shaped stents in 3 patients, and T-shaped stents in 1 patient. All patients provided informed consent and this study was approved by the Medical Ethics Committee of Henan Provincial People's Hospital, China. Blood gas analysis was performed before and 30 days after surgery to measure blood oxygen level. Quality of life was assessed by card score. The position of stent, intraluminal endocrine, and granulation growth were dynamically monitored by bronchoscopy at 7, 30 and 60 days after surgery.

RESULTS AND CONCLUSION: Silicone airway stents were placed successfully in seven patients. Dyspnea was relieved immediately. One patient had rupture of left main bronchial membrane during the procedure of insertion. The partial oxygen pressure and chi-square score of seven patients at 30 days after surgery were significantly higher than those before surgery (t=-8.60, -20.76, P < 0.05). Tracheoscopy revealed that stent displacement occurred in 3 patients, difficulty in sputum expectoration and mild granulation tissue hyperplasia occurred in 3 patients, and improved after endoscopic treatment. The results suggest that silicone stent insertion in patients with tracheobronchomalacia can alleviate the symptoms of patients. Although the incidence of silicone stent displacement and sputum obstruction is high, silicone stent insertion is still an important treatment method.

Key words: tracheobronchomalacia, silicone stent, T tube, stent displacement, bronchoscopy, rigid tracheoscope, interventional therapy, granulation tissue

CLC Number: