Suture fixation of tracheal stents for the treatment of upper trachea stenosis: a retrospective study

Huang, Jingtao; Zhang, Zhongwei; Zhang, Tao

doi:10.1186/s13019-018-0790-x

Cited by 12 publications

(11 citation statements)

References 19 publications

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“…Following the resumption of operations, one patient with CTTS was referred to surgery after dilation and one patient with web-like stenosis was followed up with bronchoscopy after dilation. [16,18] Rigid bronchoscopy is the preferred procedure for massive or uncontrolled hemoptysis because of its advantage in securing the airway and providing ventilation. [19] In our study, 2 patients with hemoptysis underwent IBP.…”

Section: Discussionmentioning

confidence: 99%

“…One of 3 patients with PITS and stent migration was left to secondary healing and bronchoscopic follow-up, while the stents of the other two were sutured to the trachea to prevent migration recurrence. [16,18] Studies suggested two consecutive negative swab-PCR results prior to bronchoscopic procedures. In the first weeks of the pandemic period, bronchoscopy was performed if there was no clinical signs and if there was no finding compatible with CP in chest CT scans.…”

Section: Discussionmentioning

confidence: 99%

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Interventional bronchoscopic approach to emergent/urgent situations in the era of Covid-19

Chouseın¹

2021

South Clin Ist Euras

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The Covid-19 pandemic has caused delays in elective medical and surgical procedures in accordance with the measures and precautions to be taken. Alternative, low transmission risk procedures had to be adopted. Urgent and emergent interventional bronchoscopic procedures (IBP) were continued to be performed in life-threatening conditions. We aimed to evaluate the IBP performed during the ongoing pandemic in terms of patient selection, diagnoses, emergency/urgency, type of procedure used, success, and complications.Methods: Patients who underwent IBP in the first wave of pandemic between March 11, 2020, when the first patient was diagnosed with Covid-19, and June 1, 2020, in Turkey.Results: Twenty-one patients with a mean age of 54.7±17 years underwent 23 emergent/ urgent IBP. Nine patients had malignant and 9 had benign airway obstruction. The remaining 3 patients were diagnosed with hemoptysis and pulmonary alveolar proteinosis.The success rate of IBP treatment was 100%, the acute complication rate was 4.7%, the chronic complication rate was 4.7%, the procedural mortality was 0.0% and the 30-days early mortality rate was 9%. All procedures were performed in interventional pulmonology (IP) unit with negative room pressure with as few auxiliary staff as possible. None of our team members developed signs and symptoms of coronavirus disease with the contribution of the constantly updated literature to our increasing clinical experience and measures taken. Conclusion:IBP can be performed with high success and low complication rates, even under pandemic conditions, especially in emergent/urgent life-threatening situations such as central airway obstructions, massive hemoptysis, and other diseases, in the absence of other surgical and invasive procedures. They have a life-saving, survival-prolonging and time-saving role up to primary therapy, provided that all necessary precautions are taken.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interventional bronchoscopic approach to emergent/urgent situations in the era of Covid-19

Chouseın¹

2021

South Clin Ist Euras

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“…The advent of silicone stents for airway stenosis has increased the number of patients that can be managed through endoscopic means. External and internal fixation of these stents can decrease the rates of migration …”

Section: Discussionmentioning

confidence: 99%

“…In particular, stent migration has been commonly reported in the literature, ranging from 16–34% . Techniques to prevent migration include appropriate stent size, design of stents, or methods to secure the stent in place . Multiple techniques to endoscopically secure stents or keels exist, but these are oftentimes tedious and cumbersome, and can even require devoted surgical instruments (ie, Lichtenberger needle) .…”

Section: Introductionmentioning

confidence: 99%

The suction‐assisted endoscopic suture technique: A simple method for endotracheal suturing

Charous

Westfall

2019

The Laryngoscope

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Background: Silicone stents are commonly employed to treat subglottic stenosis. A frequent complication is the tendency of stents to migrate. As such, various techniques to secure stents have been developed over the years, none of which have gained large popularity. We present a novel, low-cost, and easy-to-perform technique herein.Objectives: To describe a novel surgical technique to secure silicone stents and prevent migration for management of subglottic stenosis.Materials and Methods: After standard excision and dilation of stenotic portions in the subglottic or trachea. A silicone stent is introduced in a standard fashion. To secure the stent, an 18-G needle loaded with braided suture is inserted through skin, trachea, and stent. Endoscopic visualization then permits the surgeon to grasp the suture with forceps. A separate transcutaneous puncture site is performed with an 18-G needle attached to a 10-cc syringe (plunger removed) and blue tip suction within the empty syringe, creating an airtight suctioning tool. The grasped suture is gently introduced into the eye of the needle and quickly travels into the 10-cc syringe with suction assist, leaving both extracorporeal ends of the suture to tie.Results: This stitch has been employed on seven occasions on four patients. There have been no episodes of stent migration. A laboratory model found the 18-G needle and braided 3-0 suture performed optimally.Conclusions: We present a novel surgical technique to secure silicone stents in management subglottic or tracheal stenosis.

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“…It has been recommended, preferably to a metal stent or in those patients who are not a candidate for surgery (65,68). Although it has shown an improvement in symptoms (up to 100%) and a low migration rate (0 to 22%), it has never been popular due to having a difficult technique and a high rate of complication (55% stent and 100% external fixation related in one series) (65,(68)(69)(70)(71).…”

Section: A B D Cmentioning

confidence: 99%

Idiopathic subglottic stenosis: a review

et al. 2020

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Idiopathic subglottic stenosis (iSGS) is a fibrotic disease of unclear etiology that produces obstruction of the central airway in the anatomic region under the glottis. The diagnosis of this entity is difficult, usually delayed and confounded with other common respiratory diseases. No apparent etiology is identified even after a comprehensive workup that includes a complete history, physical examination, pulmonary function testing, auto-antibodies, imaging studies, and endoscopic procedures. This approach, however, helps to exclude other conditions such as granulomatosis with polyangiitis (GPA). It is also helpful to characterize the lesion and outline management strategies. Therapeutic endoscopic procedures and surgery are the most common management modalities, but medical therapy can also play a significant role in preventing or delaying recurrence. In this review, we describe the morphology, pathophysiology, clinical presentation, evaluation, management, and prognosis of iSGS.

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Suture fixation of tracheal stents for the treatment of upper trachea stenosis: a retrospective study

Cited by 12 publications

References 19 publications

Interventional bronchoscopic approach to emergent/urgent situations in the era of Covid-19

Interventional bronchoscopic approach to emergent/urgent situations in the era of Covid-19

The suction‐assisted endoscopic suture technique: A simple method for endotracheal suturing

Idiopathic subglottic stenosis: a review

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