Remove airway ultraflex stents by flexible bronchoscope

Fu Tsai Chung, Guan Yuan Chen, Chun Liang Chou, Hao Cheng Chen, Chih Teng Yu, Chih Hsi Kuo, Shu Min Lin, Han Pin Kuo

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

INTRODUCTION: Despite removal of airway metallic stents by rigid bronchoscope was presented, there are few reports describing such removal by flexible bronchoscope. METHODS: 36 patients who had airway Ultraflex stents removed by flexible bronchoscope from 2002 to 2009 were reviewed. Factors contributing to removal method and complications during and after removal were analyzed by multinomial logistic regression. RESULTS: Among 36 patients with stent extraction; 17 stents (47.2%) were removed by a single procedure and 19 (52.8%) by multiple procedures. There was no mortality or severe morbidity during or after stent removal. There were 21 complications after stent removal, including retained stent pieces (n = 9), mucosal tear with bleeding (n = 5), and re-obstruction requiring silicone stent placement (n = 7). Stent indwelling time >10 months (adjusted odds ratio: 9.5; 95% confidence interval: 7.9-11.1, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 5.2; 95% confidence interval: 2.2-8.6, P=0.01), and stent fracture before removal (adjusted odds ratio: 3.5; 95% confidence interval: 1.8-15.4, P=0.04) were independent predictors of the need for multiple procedures for stent removal. Stent indwelling time >10 months (adjusted odds ratio: 4.2; 95% confidence interval: 2.1-8.9, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 16.5; 95% confidence interval, 1.8-49.6, P=0.01), and multiple procedures required for removal (adjusted odds ratio: 6.9; 95% confidence interval, 1.1-43.5, P=0.04) were independent predictors of removal complications. CONCLUSIONS: A flexible bronchoscope can be used to remove stents in patients with central airway obstruction and stent-related complications. This procedure should be performed in centers with experienced multidisciplinary teams.

Original languageEnglish
Pages (from-to)267-272
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume343
Issue number4
DOIs
Publication statusPublished - Jan 1 2012
Externally publishedYes

Fingerprint

Bronchoscopes
Stents
Odds Ratio
Confidence Intervals
Granulation Tissue
Silicones
Airway Obstruction

Keywords

  • Complications
  • Flexible bronchoscope
  • Multiple procedures
  • Stent removal
  • Ultraflex

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Remove airway ultraflex stents by flexible bronchoscope. / Chung, Fu Tsai; Chen, Guan Yuan; Chou, Chun Liang; Chen, Hao Cheng; Yu, Chih Teng; Kuo, Chih Hsi; Lin, Shu Min; Kuo, Han Pin.

In: American Journal of the Medical Sciences, Vol. 343, No. 4, 01.01.2012, p. 267-272.

Research output: Contribution to journalArticle

Chung, Fu Tsai ; Chen, Guan Yuan ; Chou, Chun Liang ; Chen, Hao Cheng ; Yu, Chih Teng ; Kuo, Chih Hsi ; Lin, Shu Min ; Kuo, Han Pin. / Remove airway ultraflex stents by flexible bronchoscope. In: American Journal of the Medical Sciences. 2012 ; Vol. 343, No. 4. pp. 267-272.
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abstract = "INTRODUCTION: Despite removal of airway metallic stents by rigid bronchoscope was presented, there are few reports describing such removal by flexible bronchoscope. METHODS: 36 patients who had airway Ultraflex stents removed by flexible bronchoscope from 2002 to 2009 were reviewed. Factors contributing to removal method and complications during and after removal were analyzed by multinomial logistic regression. RESULTS: Among 36 patients with stent extraction; 17 stents (47.2{\%}) were removed by a single procedure and 19 (52.8{\%}) by multiple procedures. There was no mortality or severe morbidity during or after stent removal. There were 21 complications after stent removal, including retained stent pieces (n = 9), mucosal tear with bleeding (n = 5), and re-obstruction requiring silicone stent placement (n = 7). Stent indwelling time >10 months (adjusted odds ratio: 9.5; 95{\%} confidence interval: 7.9-11.1, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 5.2; 95{\%} confidence interval: 2.2-8.6, P=0.01), and stent fracture before removal (adjusted odds ratio: 3.5; 95{\%} confidence interval: 1.8-15.4, P=0.04) were independent predictors of the need for multiple procedures for stent removal. Stent indwelling time >10 months (adjusted odds ratio: 4.2; 95{\%} confidence interval: 2.1-8.9, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 16.5; 95{\%} confidence interval, 1.8-49.6, P=0.01), and multiple procedures required for removal (adjusted odds ratio: 6.9; 95{\%} confidence interval, 1.1-43.5, P=0.04) were independent predictors of removal complications. CONCLUSIONS: A flexible bronchoscope can be used to remove stents in patients with central airway obstruction and stent-related complications. This procedure should be performed in centers with experienced multidisciplinary teams.",
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AU - Kuo, Chih Hsi

AU - Lin, Shu Min

AU - Kuo, Han Pin

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N2 - INTRODUCTION: Despite removal of airway metallic stents by rigid bronchoscope was presented, there are few reports describing such removal by flexible bronchoscope. METHODS: 36 patients who had airway Ultraflex stents removed by flexible bronchoscope from 2002 to 2009 were reviewed. Factors contributing to removal method and complications during and after removal were analyzed by multinomial logistic regression. RESULTS: Among 36 patients with stent extraction; 17 stents (47.2%) were removed by a single procedure and 19 (52.8%) by multiple procedures. There was no mortality or severe morbidity during or after stent removal. There were 21 complications after stent removal, including retained stent pieces (n = 9), mucosal tear with bleeding (n = 5), and re-obstruction requiring silicone stent placement (n = 7). Stent indwelling time >10 months (adjusted odds ratio: 9.5; 95% confidence interval: 7.9-11.1, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 5.2; 95% confidence interval: 2.2-8.6, P=0.01), and stent fracture before removal (adjusted odds ratio: 3.5; 95% confidence interval: 1.8-15.4, P=0.04) were independent predictors of the need for multiple procedures for stent removal. Stent indwelling time >10 months (adjusted odds ratio: 4.2; 95% confidence interval: 2.1-8.9, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 16.5; 95% confidence interval, 1.8-49.6, P=0.01), and multiple procedures required for removal (adjusted odds ratio: 6.9; 95% confidence interval, 1.1-43.5, P=0.04) were independent predictors of removal complications. CONCLUSIONS: A flexible bronchoscope can be used to remove stents in patients with central airway obstruction and stent-related complications. This procedure should be performed in centers with experienced multidisciplinary teams.

AB - INTRODUCTION: Despite removal of airway metallic stents by rigid bronchoscope was presented, there are few reports describing such removal by flexible bronchoscope. METHODS: 36 patients who had airway Ultraflex stents removed by flexible bronchoscope from 2002 to 2009 were reviewed. Factors contributing to removal method and complications during and after removal were analyzed by multinomial logistic regression. RESULTS: Among 36 patients with stent extraction; 17 stents (47.2%) were removed by a single procedure and 19 (52.8%) by multiple procedures. There was no mortality or severe morbidity during or after stent removal. There were 21 complications after stent removal, including retained stent pieces (n = 9), mucosal tear with bleeding (n = 5), and re-obstruction requiring silicone stent placement (n = 7). Stent indwelling time >10 months (adjusted odds ratio: 9.5; 95% confidence interval: 7.9-11.1, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 5.2; 95% confidence interval: 2.2-8.6, P=0.01), and stent fracture before removal (adjusted odds ratio: 3.5; 95% confidence interval: 1.8-15.4, P=0.04) were independent predictors of the need for multiple procedures for stent removal. Stent indwelling time >10 months (adjusted odds ratio: 4.2; 95% confidence interval: 2.1-8.9, P=0.01), obstructive granulation tissue formation before stent removal (adjusted odds ratio: 16.5; 95% confidence interval, 1.8-49.6, P=0.01), and multiple procedures required for removal (adjusted odds ratio: 6.9; 95% confidence interval, 1.1-43.5, P=0.04) were independent predictors of removal complications. CONCLUSIONS: A flexible bronchoscope can be used to remove stents in patients with central airway obstruction and stent-related complications. This procedure should be performed in centers with experienced multidisciplinary teams.

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