Surgery is a well-recognized modality of treatment for benign tracheobronchial
stenosis. However, in some benign disease groups, such as
tuberculosis,
sarcoidosis, war gas exposure, and
inhalation burns, multiplicity of involvement or long length of stenosed segment heightens surgical challenge. We investigated the outcomes and long-term tolerability of the Natural
stent (N-
stent) in such patients with post-
tuberculosis tracheobronchial
stenosis. A retrospective review was done for 17 patients who underwent
silicone stenting (N-
stent) for post-
tuberculosis tracheobronchial
stenosis during January 2000-December 2003 but needed persistent
stent placement and still require the
stent. Significant increase in the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), expressed as FEV1%, as well as in forced percentual vital capacity (FVC%) (Δ24% and Δ11%, respectively) in the short term and sustained increase in the FEV1% and FVC% (Δ26.5% and Δ16.5%, respectively) in the long term were noted at a median (range) interval of 1 (0.5-72) month and 72 (12-114) months, respectively, along with symptomatic relief. No procedure-related death occurred.
Stent-related late complications included granulation tissue formation (76%), migration (70%), and mucostasis (17%). The median duration for which N-
stents were tolerated was 7.9 (range, 3-11) years. N-
stents are well-tolerated for a prolonged period.
Stent-related complications occur, but are easily managed. These results might carry medical implications for those who have airway lesions difficult to correct surgically.