The safety and effectiveness of the treatment of refractory post-intubation subglottic stenosis using short bronchial Dumon stent: a pilot study

Zuyuan Guo; Yongshun Ye; Yu Chen; Zhuquan Su; Weiquan Xiao; Liya Lu; Nanshan Zhong; Shiyue Li; Xiaobo Chen

doi:10.21037/jtd-24-342

The safety and effectiveness of the treatment of refractory post-intubation subglottic stenosis using short bronchial Dumon stent: a pilot study

J Thorac Dis. 2024 Aug 31;16(8):4844-4851. doi: 10.21037/jtd-24-342. Epub 2024 Aug 12.

Authors

Zuyuan Guo^#¹, Yongshun Ye^#², Yu Chen¹, Zhuquan Su¹, Weiquan Xiao¹, Liya Lu³, Nanshan Zhong¹, Shiyue Li¹, Xiaobo Chen¹

Affiliations

¹ State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
² Department of Pulmonary and Critical Care Medicine, Huizhou Municipal Central Hospital, Huizhou, China.
³ Department of Anesthesiology Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

^# Contributed equally.

Abstract

Background: Post-intubation subglottic stenosis (PI-SGS) is a fatal disease which could result in partial or complete narrowing of the airway. Although airway stenting is commonly used as an alternative treatment for PI-SGS patients unsuitable for surgery, complications including stent migration and excessive granulation tissue formation are frequently encountered. Additionally, tracheotomy is necessary in patients undergoing T-tube placement. Therefore, it is necessary to further enhance the effectiveness of airway stenting in refractory PI-SGS. In this study, we aimed to evaluate the safety and effectiveness of utilizing short bronchial Dumon (BD) stents in managing refractory PI-SGS.

Methods: PI-SGS patients who were not suitable for surgery and in whom previous interventional treatments had proven ineffective were enrolled. Short BD stents were inserted via rigid bronchoscopy under general anesthesia. Complications and outcomes were assessed by follow-ups.

Results: Fourteen patients were included and successful stent insertion was achieved in all cases. The median diameter and length of stents was 12 (0.25) and 33.5 (5) mm, respectively. During the 6-month follow-up period, complications were reported in five patients. Granulation tissue formation was the most frequently observed complication (4 in 14 patients, 28.57%), followed by stent migration (2 in 14 patients, 14.29%). Out of the total participants, 11 patients (78.57%) demonstrated good tolerance to the stent, while 3 (21.43%) required stent removal. Among these three patients, two finally underwent subsequent T-tube insertion after the removal. Twelve patients (85.71%) avoided the tracheotomy and T-tube insertion.

Conclusions: The utilization of short BD stents appears to be a safe and effective approach for managing refractory PI-SGS. The complications and tolerability are acceptable.

Keywords: Treatment; bronchial Dumon stent (BD stent); interventional pulmonology; refractory post-intubation subglottic stenosis (refractory PI-SGS).