tailieunhanh - Báo cáo y học: "Flexible bronchoscopic management of benign tracheal stenosis: long term follow-up of 115 patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Flexible bronchoscopic management of benign tracheal stenosis: long term follow-up of 115 patients. | Rahman et al. Journal of Cardiothoracic Surgery 2010 5 2 http content 5 1 2 JOTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Flexible bronchoscopic management of benign tracheal stenosis long term follow-up of 115 patients Nader Abdel Rahman Oren Fruchter David Shitrit Benjamin D Fox Mordechai R Kramer Abstract Background Management of benign tracheal stenosis BTS varies with the type and extent of the disease and influenced by the patient s age and general health status hence we sought to investigate the long-term outcome of patients with BTS that underwent minimally invasive bronchoscopic treatment. Methods Patients with symptomatic BTS were treated with flexible bronchoscopy therapeutic modalities that included the following balloon dilatation laser photo-resection self-expanding metal stent placement and High-dose rate endobronchial brachytherapy used in cases of refractory stent-related granulation tissue formation. Results A total of 115 patients with BTS and various cardiac and respiratory co-morbidities with a mean age of 61 range 40-88 were treated between January 2001 and January 2009. The underlining etiologies for BTS were post -endotracheal intubation N 76 post-tracheostomy N 30 Wegener s granulomatosis N 2 sarcoidosis N 2 amyloidosis N 2 and idiopathic BTS N 3 . The modalities used were balloon dilatation and laser treatment N 98 . Stent was placed in 33 patients of whom 28 also underwent brachytherapy. Complications were minor and mostly included granulation tissue formation. The overall success rate was 87 . Over a median follow-up of 51 months range 10-100 months 30 patients 26 died mostly due to exacerbation of their underlying conditions. Conclusions BTS in elderly patients with co-morbidities can be safely and effectively treated by flexible bronchoscopic treatment modalities. The use of HDR brachytherapy to treat granulation tissue formation following successful airway restoration is promising. .