Long-term outcomes of tracheal stents removal under fluoroscopy guidance: comparison of tracheal fistulas with tracheal stenosis

Abstract

Background: No study compared the techniques and complications of stent removal under fluoroscopy guidance for tracheal fistula and tracheal stenosis.Methods: We conducted a retrospective analysis of 152 patients who underwent fluoroscopy-guided stent removal from January 2011 to June 2017. Eighty-five patients underwent stent removal for tracheal fistula (TF group), and 67 patients for tracheal stenosis (TS group). All patients underwent tracheal CT scans before stent removal and during follow up. The technical success rate, complications, survival rate were compared between the two groups.Results: The technical success rate of stent removal was 98.9% and 97.4% for tracheal fistula and tracheal stenosis, respectively. Except for the routine removal for half of patients, excessive granulation tissue was the common indications for stent removal, which was found 142.1±25.9 days later for tracheal fistula, and 89.9±15.0 day for tracheal stenosis. The total incidence of complications was 21.1% and 22.4% for tracheal fistula and tracheal stenosis, respectively. One perioperative death of asphyxia was found in TF group, and 2 deaths in TS group. Recurrence of fistula or stenosis requiring stenting was the most comment complication in both groups. The 0.5-, 3-, 6-year survival rates were 90.3%, 59.6%, and 36.1% for TF group, and 80.4%, 75.7%, 75.7% for TS group.Conclusions: Fluoroscopic removal of tracheal stent is safe and effective for both tracheal fistula and tracheal stenosis, with no significant difference. Recurrence of fistula or stenosis requiring stenting was the most comment complication.