Objective: Tracheal stenting for cicatricial stenoses is reserved for patie
nts whose lesions are deemed inoperable for local or general reasons. The a
im of our study was to verify the long-term results of silicone tracheal st
ents in such a clinical setting.
Methods: Clinical data of 45 patients treated by tracheal silicone stents,
between 1987 and 1999, were reviewed. All patients had highly symptomatic c
icatricial stenoses; they were selected for stenting rather than for surger
y because of local and general conditions. This series has been divided in
two groups according to the purpose of stenting: bridge to surgery or defin
itive treatment. Follow-up ranged between 12 and 83 months. Twenty-seven pa
tients received a Montgomery T tube (Hood Laboratories, Pembroke, Mass), 16
a Dumon stent (Novatech, Plan de Gras, France), and 2 a Dynamic stent (Rus
ch, Kernen, Germany).
Results: No procedure-related mortality was observed. Nine patients underwe
nt curative resection and reconstruction after a variable stenting period;
one had a recurrent stenosis and was treated for palliation with a T tube.
Tracheal stenting was performed for palliation as a definitive treatment in
37 patients. Among this group, 11 patients died of unrelated causes at a m
edian of 10 months after the endoscopic treatment. The stent was permanentl
y removed in 10 after a median interval of 32 months (range 9-70 months); i
n 4 others, symptomatic recurrence of the stenosis was observed within 6 we
eks of stent removal. None of the patients successfully decannulated had a
completely normal tracheal lumen but all remained asymptomatic because the
residual stenosis was mild or well tolerated for concomitant limitation of
physical activity.
Conclusions: Long-term treatment with a silicone stent was safe and well to
lerated in cicatricial tracheal stenoses. This procedure can be considered
as a bridge to curative surgery or as a definitive treatment. The latter, g
enerally performed for palliation, may provide satisfactory therapeutic res
ults in selected patients, even in the presence of severe circumferential s
tenoses.