[The role of tracheobronchial stenting in the management of pediatric airway obstruction].

PURPOSE

Tracheobronchial stenting can aid in the management of pediatric airway problems. We reviewed our experience to determine the role of endoscopic airway stents in children.

METHODS

Sixteen children (Age range: 10 days- 19 years) underwent 28 tracheobronchial stents in the period 1991-2006. The stent type chosen depended on patient age and location. All procedures were done under general anesthesia with bronchoscopy. The following features have been taken into account: etiology, obstruction diagnosis, stent type, localization,,associated anomalies, complications, results, and time of follow-up.

RESULTS

Etiology of the tracheobronchial obstruction included tracheobronchiomalacia in 13 patients (81.3%), tracheal stenosis in 2 (12.5%) and glotic stenosis in one case (6.2%). The stent used were 15 Palmaz (53.5%), 7 Dumon (25%), 4 Montgomey (14.5%), 1 Poliflex (3.5%) and one Dynamic stent (3.5%). More than one stent were undertaken in seven cases (43.7%). 16 patients had tracheal stents, 11 children had bronchial stent and one infant a carinal stent. Five complications are reported (two patients developed granulation tissue, two stents migrated, and a child presented a left lung atelectasis) and five patients died (only one case related to tracheobronchial stenting). Results have been satisfactory in 14 patients (87.5%) and the mean time of follow-up has been two years and ten months (range 2 months- 12 years and 6 months).

CONCLUSIONS

The tracheobronchial stenting in children may represent a valid treatment option for many sick children in particular circumstances. The long-term outcome remains uncertain but the medium-term outlook is encouraging.