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The Short Term and Intermediate Term Results of using a T-tube in Patients with Tracheal Stenosis  

Sa, Young Jo (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Moon, Seok-Whan (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Kim, Young-Du (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Jin, Ung (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Park, Jae-Kil (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Kim, Jae Jun (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Kim, Chi-Kyung (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Jo, Keon Hyon (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Park, Chan Beom (Department of Thoracic and Cardiovascular Surgery, The Catholic University of Korea College of Medicine)
Yim, Hyeon Woo (Department of Preventive Medicine, The Catholic University of Korea College of Medicine)
Publication Information
Journal of Chest Surgery / v.42, no.1, 2009 , pp. 63-71 More about this Journal
Abstract
Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.
Keywords
Tracheal stenosis; Treacheostomy;
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1 Choi JY, Jang IS, Kim JW, et al. Surgical treatment of tracheal stenosis. Korean J Thorac Cardiovasc Surg 2000; 33:565-9
2 Lang FJ, Hurni M, Monnier P. Long segment congenital tracheal stenosis: treatment by slide tracheoplasty. J Pediatr Surg 1999;34:1216-22   DOI
3 Montgomery WW. The surgical management of supraglottic and subglottic stenosis. Ann Otol Rhinol Laryngol 1968;77: 534-46   DOI
4 Dumon JF. A dedicated tracheobronchial stent. Chest 1990; 97:328-32   DOI   ScienceOn
5 Puma F, Ragusa M, Aventia N, et al. The role of silicone stents in the treatment of cicatricial tracheal stenoses. J Thorac Cardiovasc Surg 2000;120:1064-9   DOI   ScienceOn
6 Cooper JD, Todd TR, Ilves R, Pearson FG. Use of the silicone tracheal T-tube for the management of complex tracheal injuries. J Thorac Cardiovasc Surg 1981;82:559-68
7 Vacanti CA, Paige KT, Kim WS, Sakata J, Upton J, Vacanti JP. Experimental tracheal replacement using tissue-engineered cartilage. J Pediatr Surg 1994;29:201-5   DOI   ScienceOn
8 Bando K, Turrentine MW, Sun K, et al. Anterior pericardial tracheoplasty for congenital tracheal stenosis: intermediate to long-term outcomes. Ann Thorac Surg 1996;62:981-9   DOI   ScienceOn
9 Stauffer JL, Olson DE, Pett TL. Complications and consequences of endotracheal intubations and tracheostomy. a prospective study of 150 critically Ill patients. Am J Med 1981;70:65-76   DOI   ScienceOn
10 Jacobs JP, Quintessenza JA, Botero LM, et al. The role of airway stents in the management of pediatric tracheal, carinal, and bronchial disease. Eur J Cardiothorac Surg 2000;18:505-12   DOI   ScienceOn
11 Pearson FG, Andrews MJ. Detection and management of tracheal stenosis following cuffed tube tracheostomy. Ann Thoracic Surg 1971;12:359-74   DOI   ScienceOn
12 Martinez-Ballarin JI, Diaz-Jimenez JP, Castro MJ, Moya JA. Silicone stents in the management of benign tracheobronchial stenoses. Tolerance and early results in 63 patients. Chest 1996:109:626-9   DOI   ScienceOn
13 Cooper GD, Pearson FG, Patterson GA, et al. Use of silicone stents in the management of airway problems. Ann Thorac Surg 1989;47:371-8   DOI   ScienceOn
14 Wu CY, Liu YH, Hsieh MJ, et al. Airway stents in management of tracheal stenosis: have we improved? ANZ J Surg 2007;77:27-32   DOI   ScienceOn
15 .Kim CK, Yoon JS, Kwack MS, Kim SW, Lee HK. Surgical management of tracheal stenosis. Korean J Thorac Cardiovasc Surg 1992;25:1508-15
16 Gaissert HA, Grillo HC, Mathisen DJ, Wain JC. Temporary and permanent restoration of airway continuity with the tracheal T-tube. J Thorac Cardiovasc Surg 1994;107:600-6
17 deLorimier AA, Harrison MR, Hardy K, Howell LJ, Adzick NS. Tracheobronchial obstruction in infants and children. Experience with 45 cases. Ann Surg 1990;212:277-89   DOI   ScienceOn
18 Wahidi MM, Ernst A. The montgomery T-tube tracheal stent. Clin Chest Med 2003;24:437-43   DOI   ScienceOn
19 Whited RE. Laryngeal dysfunction following prolonged intubation. Ann Otol Rhinol Laryngol 1979;88:474-8   DOI
20 Liu HC, Lee KS, Huang CJ, Cheng CR, Hsu WH, Huang MH. Silicone T-tube for complex laryngotracheal problems. Eur J Cardiothorac Surg 2002;21:326-30   DOI   ScienceOn