Department of Anesthesiology, UCLouvain, CHU UCL Namur (Godinne site), Yvoir, Belgium.
Department of Pneumology, UCLouvain, CHU UCL Namur (Godinne site), Yvoir, Belgium.
BMC Pulm Med. 2024 Aug 9;24(1):383. doi: 10.1186/s12890-024-03197-1.
A straight silicone stent can be used to treat proximal benign tracheal stenosis in non-surgical candidates. However, stent migration is a common complication when placed at a particular location and can lead to major complications. This case series of laryngotracheal stenosis reports a fixation method for straight silicone stents in the subglottic trachea (Stage 3 of the McCaffrey classification).
The medical charts of these patients scheduled for straight silicone stent placement with suture fixation between 2014 and 2020 at the CHU UCL Namur Hospital (Belgium) were retrospectively reviewed. The procedure was performed using a rigid bronchoscope. Details of the procedure were obtained from medical records.
This case series included six patients (males: 4, females: 2). The median patient age was 59 years. Two suture fixations were placed following previous silicone stent migration episodes, whereas the others were placed proactively to avoid this risk. All fixations were performed by the device Freka Pexact II ENFIt, originally developed for gastropexy in endoscopic gastrostomy. The sutures were subcutaneously buried.
During the 6-month follow-up period, complications such as fixation issues and stent migration were reported despite the off-label use of the treatment. The straight silicone stent fixation technique used in this case series was simple and effective for securing the stent in upper benign tracheal stenosis.
对于不能手术的近端良性气管狭窄患者，可以使用直型硅酮支架进行治疗。然而，当支架放置在特定位置时，支架迁移是一种常见的并发症，可能导致严重的并发症。本喉气管狭窄病例系列报告了一种在声门下气管（McCaffrey 分类第 3 期）中固定直型硅酮支架的方法。
回顾性分析了 2014 年至 2020 年期间在比利时 CHU UCL Namur 医院因直型硅酮支架置入术而行缝线固定的患者的病历。该手术使用硬性支气管镜进行。手术细节从病历中获得。
本病例系列包括 6 名患者（男性 4 名，女性 2 名）。中位患者年龄为 59 岁。2 例因先前的硅酮支架迁移事件而进行了 2 次缝线固定，而其他患者则进行了预防性固定以避免这种风险。所有固定均由 Freka Pexact II ENFIt 装置进行，该装置最初是为内镜胃造口术的胃固定而开发的。缝线皮下埋藏。
尽管该治疗方法属于超适应证使用，但在 6 个月的随访期间，仍报告了固定问题和支架迁移等并发症。本病例系列中使用的直型硅酮支架固定技术对于固定上气道良性狭窄的支架是简单有效的。
