Cryotherapy in management of postintubation tracheal stenoses-single center experience

Cryotherapy is used mainly in palliation of central airway tumors, cryobiopsy and foreign body removal, but also in treatment of benign conditionsThe aim of the study is to present our experience in using cryotherapy in treatment of granulation tissue following post-intubation stenosisIn period of 2011-2016. in Bronchoscopy Department of University Hospital for Pulmonology in Belgrade, we performed 27 such interventions for postintubation stenosis (PIS) using both flexible and rigid cryoprobe.In 8 patients (pts) PIS was discovered less than 3 weeks after initial intubation; in 3 pts unsuccessful weaning from mechanical ventilation was reason for bronchoscopy. In 10 pts diagnosis was made 3-8 weeks from intubation, while in 9 patients, in whom PIS remained undiscovered for more than 2 months, significant stenosis occurred. In 4 of them, obstruction of the central airway was mistreated as asthma /COPD more than a year after intubation. Time to diagnosis varied from 6 days to 18 months. In 12 pts "difficult airway" was reported, suggesting possible intubation trauma. All pts underwent rigid mechanical dilatation before cryotherapy. Cryotherapy was performed in 4 to 11 sessions and success rate (achieving airway patency more than 70% of tracheal lumen) was highest in first 2 groups of patients (72.2%-13 pts) where fresh granulation tissue was present. Cryotherapy was inefficient in 4 pts in whom stenosis lasted more than a year after intubation. Limitation of the study is that al...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional Pulmonology Source Type: research