{"title":"Clinical Analysis of 32 Cases of Subglottic Benign Airway Stenosis Treated With Montgomery T Silicone Stent.","authors":"Zhenyu Yang, Xiaoli Zhou, Wenying Pan, Daxiong Zeng, Junhong Jiang","doi":"10.1155/2024/2145560","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> To explore the complications of long-term placement of Montgomery T silicone stent (T<i>-</i>tube) in the treatment of subglottic benign airway stenosis (SBAS) and the timing of successful T<i>-</i>tube removal. <b>Methods:</b> We retrospectively collected the clinical data of 32 patients with SBAS who underwent the treatment of T<i>-</i>tube and analyzed their placement and successful removal of the T<i>-</i>tube. <b>Results:</b> There were 22 males and 10 females, aged from 21 to 79 years (60.9 ± 13.7 years). The T<i>-</i>tubes were successfully placed in all 32 patients, and 6 patients (18.8%) with mild stenosis were placed by the intravenous conscious sedation. The longest follow-up period was 60.4 months, and 17 patients (53.1%) had the T<i>-</i>tubes for more than 12 months; 5 patients (15.6%) were changed to the tracheostomy cannula after unplanned removal of the T<i>-</i>tubes for various reasons; the T<i>-</i>tubes were successfully removed in 9 patients (28.1%), and the duration of T<i>-</i>tubes placement was 5.2-22.7 months (12.1 ± 6.3 months), among them anatomical stenosis in 9 patients (100%). Secretion retention was observed in 32 patients (100%), granulation tissue hyperplasia was observed in 9 patients (28.1%), and the normal ventilation was not affected in most patients by bronchoscopic treatment and follow-up; the T<i>-</i>tubes were removed in 3 patients due to severe complications. There was no significant difference in the incidences of secretion retention and granulation tissue hyperplasia between the time point at 1 week, 1 month, 3 months, and 12 months, <i>p</i> > 0.05. In patients with T<i>-</i>tube more than 12 months, the severity of secretion retention at 1 week, 1 month, 3 months, and 12 months was significantly different, <i>p</i> < 0.05, however, there was no significant difference in the severity of granulation tissue hyperplasia, <i>p</i> > 0.05. <b>Conclusions:</b> T<i>-</i>tube is safe and effective in the treatment of SBAS. The severity of secretion retention increased in patients with long-term placement of the T<i>-</i>tube. For patients with mild stenosis and anatomical stenosis, the T<i>-</i>tube removal can be attempted at about 1 year of follow-up.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498979/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian respiratory journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2024/2145560","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To explore the complications of long-term placement of Montgomery T silicone stent (T-tube) in the treatment of subglottic benign airway stenosis (SBAS) and the timing of successful T-tube removal. Methods: We retrospectively collected the clinical data of 32 patients with SBAS who underwent the treatment of T-tube and analyzed their placement and successful removal of the T-tube. Results: There were 22 males and 10 females, aged from 21 to 79 years (60.9 ± 13.7 years). The T-tubes were successfully placed in all 32 patients, and 6 patients (18.8%) with mild stenosis were placed by the intravenous conscious sedation. The longest follow-up period was 60.4 months, and 17 patients (53.1%) had the T-tubes for more than 12 months; 5 patients (15.6%) were changed to the tracheostomy cannula after unplanned removal of the T-tubes for various reasons; the T-tubes were successfully removed in 9 patients (28.1%), and the duration of T-tubes placement was 5.2-22.7 months (12.1 ± 6.3 months), among them anatomical stenosis in 9 patients (100%). Secretion retention was observed in 32 patients (100%), granulation tissue hyperplasia was observed in 9 patients (28.1%), and the normal ventilation was not affected in most patients by bronchoscopic treatment and follow-up; the T-tubes were removed in 3 patients due to severe complications. There was no significant difference in the incidences of secretion retention and granulation tissue hyperplasia between the time point at 1 week, 1 month, 3 months, and 12 months, p > 0.05. In patients with T-tube more than 12 months, the severity of secretion retention at 1 week, 1 month, 3 months, and 12 months was significantly different, p < 0.05, however, there was no significant difference in the severity of granulation tissue hyperplasia, p > 0.05. Conclusions: T-tube is safe and effective in the treatment of SBAS. The severity of secretion retention increased in patients with long-term placement of the T-tube. For patients with mild stenosis and anatomical stenosis, the T-tube removal can be attempted at about 1 year of follow-up.
期刊介绍:
Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.