Abstract | STUDY OBJECTIVES: To assess the efficacy and complications of different interventional bronchoscopic techniques used to treat airway complications after lung transplantation. DESIGN: Retrospective study. SETTING: Heart-lung transplant unit of a university hospital. PATIENTS: From November 1986 to January 2000, interventional bronchoscopy was performed in 41 of 312 lung transplant recipients (13.1%) for tracheobronchial stenosis, bronchomalacia, granuloma formation, and dehiscence. INTERVENTIONS: MEASUREMENTS AND RESULTS: Mean (+/- SE) improvement in FEV(1) in 26 patients undergoing dilatation for a stenotic or a combined lesion was 93 +/- 334 mL or 8 +/- 21%. In seven of these patients not proceeding to stent placement, mean improvement in FEV(1) was 361 +/- 179 mL or 21 +/- 9%. Patients needing stent placement after dilatation had a mean change in FEV(1) after dilatation of - 5 +/- 325 mL or 3 +/- 23%, and an improvement of 625 +/- 480 mL or 52 +/- 43% after stent insertion. Mean improvement in FEV(1) for patients treated with stent insertion for bronchomalacia was 673 +/- 30 mL or 81 +/- 24%. Complications of airway stents were migration (27%), mucous plugging (27%), granuloma formation (36%), stent fracture (3%), and formation of a false passage (6%). Mortality associated with interventional bronchoscopy was 2.4% (1 of 41 patients). For patients with airway complications successfully undergoing interventional bronchoscopy, the overall 1-year, 3-year, and 5-year survival rates were 79%, 45%, and 32%, respectively, vs 87%, 69%, and 56% for those without airway complications (p < 0.05). CONCLUSION: Only a small number of patients with airway stenosis after lung transplantation will respond to bronchial dilatation alone. Patients with airway complications after lung transplantation have a higher mortality than patients without airway complications.
|
Authors | P N Chhajed, M A Malouf, M Tamm, P Spratt, A R Glanville |
Journal | Chest
(Chest)
Vol. 120
Issue 6
Pg. 1894-9
(Dec 2001)
ISSN: 0012-3692 [Print] United States |
PMID | 11742919
(Publication Type: Journal Article)
|
Topics |
- Adolescent
- Adult
- Bronchial Diseases
(etiology, mortality, therapy)
- Bronchoscopy
- Cause of Death
- Child
- Dilatation
- Female
- Granuloma
(etiology, mortality, therapy)
- Humans
- Laser Therapy
- Lung Transplantation
- Male
- Middle Aged
- Postoperative Complications
(etiology, mortality, therapy)
- Prosthesis Failure
- Retreatment
- Stents
- Surgical Wound Dehiscence
(etiology, mortality, therapy)
- Survival Rate
- Tracheal Stenosis
(etiology, mortality, therapy)
|