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Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis

Korean Journal of Pediatrics 2005;48(5):512-517.
Published online May 15, 2005.
Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis
Ju Young Jang1, Hyo-Bin Kim1, So Yeon Lee1, Ja Hyung Kim1, Seong Jong Park1, Ji Hoon Shin2, Soo-Jong Hong1
1Department of Pediatrics, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea
2Department of Diagnostic Radiology, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea
기관 또는 기관지 협착을 가진 소아에서의 스텐트 적용
장주영1, 김효빈1, 이소연1, 김자형1, 박성종1, 신지훈2, 홍수종1
1울산대학교 의과대학 서울아산병원 소아과
2울산대학교 의과대학 서울아산병원 진단방사선과
Correspondence: 
Soo-Jong Hong, Email: sjhong@amc.seoul.kr
Abstract
Purpose
: In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents.
Methods
: Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent.
Results
: The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent.
Conclusion
: We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children
Key Words: Children , Airway obstruction , Airway stent , Tracheal stenosis , Bronchomalacia , Endotracheal tuberculosis


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