ENDOSCOPIC TREATMENT OF TRACHEAL STENOSIS USING THE CARBON-DIOXIDE LASER AND THE GIANTURCO STENT - INDICATIONS AND RESULTS

The self-expandable Gianturco stent was used in 11 patients with trach eal stenosis who were treated from September 1992 through July 1994. U nder optical control, the stent was placed through a bronchoscope with an outside diameter of 9 mm after cross-section and dilation of the s tenosis were performed with the carbon dioxide laser according to the Shapshay technique. The follow-up period varied from 3 to 22 months, w ith a mean of 12 +/- 6 months. Pulmonary function tests showed a mean improvement of the peak expiratory flow (50%), from 0.95 +/- 0.45 L/se c before the operation to 2.13 +/- 0.86 L/sec after the procedure, Rad iologic and fibroscopic controls showed prosthesis stability, Three pa tients needed a second endoscopic procedure because of malposition of the stent, the formation of granuloma at the superior end of the prost hesis, and the development of a mucous membrane webbing between the tw o loops of a stent, Due to the lack of long-term follow-up, this techn ique is reserved for the treatment of severe tracheal stenosis with ca rtilage impairment in patients who have contraindications for external reconstructive surgery.