Evidence against routine scheduling of surveillance bronchoscopy after stent insertion

Study objectives: To determine whether routine scheduling of surveillance f lexible fiberoptic bronchoscopy is warranted within 2 to 3 months after sil icone stent insertion for central airway obstruction, Design: Retrospective cohort study. Setting: University medical center. Patients: All patients with silicone stents placed for benign or malignant tracheobronchial obstruction during a 3-year period. Methods: Incidence of stent-related complications, new respiratory symptoms , and need for therapeutic bronchoscopic intervention were noted in patient s undergoing surveillance bronchoscopy (SFFB) and emergency bronchoscopy (E FFB), defined as flexible fiberoptic bronchoscopy prompted by onset of new symptoms before the date of scheduled SFFB. Results: One hundred one silicone stents were inserted in 88 patients (47 w ith cancer, 41 with benign disease). Eighteen patients died within 2 months and had no bronchoscopy. Seventy patients underwent either SFFB or EFFB, S tent-related complications were detected in 9 of 31 asymptomatic patients ( 29%) undergoing SFFB; all had received tumor-specific therapy after stent i nsertion (in 7 of 8 patients [88%] reporting new respiratory symptoms at th e time of SEER, and in 26 of 31 patients [84%] undergoing EFFB). Overall, s tent-related complications were detected in nine asymptomatic patients (10% of total), of which only four patients (5% of total, but 13% of all asympt omatic patients) required therapeutic interventions. Conclusion: Routine SEER within 2 to 3 months after stent insertion did not detect a high incidence of stent-related complications among patients with out new respiratory symptoms.