The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital), Department of Respiratory and Critical Care Medicine, Suzhou 215000, Jiangsu, China.
The First Affiliated Hospital of Soochow University, Department of Respiratory and Critical Care Medicine, Suzhou 215000, Jiangsu, China.
Can Respir J. 2024 Oct 16;2024:2145560. doi: 10.1155/2024/2145560. eCollection 2024.
To explore the complications of long-term placement of Montgomery T silicone stent (Ttube) in the treatment of subglottic benign airway stenosis (SBAS) and the timing of successful Ttube removal. We retrospectively collected the clinical data of 32 patients with SBAS who underwent the treatment of Ttube and analyzed their placement and successful removal of the Ttube. There were 22 males and 10 females, aged from 21 to 79 years (60.9 ± 13.7 years). The Ttubes were successfully placed in all 32 patients, and 6 patients (18.8%) with mild stenosis were placed by the intravenous conscious sedation. The longest follow-up period was 60.4 months, and 17 patients (53.1%) had the Ttubes for more than 12 months; 5 patients (15.6%) were changed to the tracheostomy cannula after unplanned removal of the Ttubes for various reasons; the Ttubes were successfully removed in 9 patients (28.1%), and the duration of Ttubes placement was 5.2-22.7 months (12.1 ± 6.3 months), among them anatomical stenosis in 9 patients (100%). Secretion retention was observed in 32 patients (100%), granulation tissue hyperplasia was observed in 9 patients (28.1%), and the normal ventilation was not affected in most patients by bronchoscopic treatment and follow-up; the Ttubes were removed in 3 patients due to severe complications. There was no significant difference in the incidences of secretion retention and granulation tissue hyperplasia between the time point at 1 week, 1 month, 3 months, and 12 months, > 0.05. In patients with Ttube more than 12 months, the severity of secretion retention at 1 week, 1 month, 3 months, and 12 months was significantly different, < 0.05, however, there was no significant difference in the severity of granulation tissue hyperplasia, > 0.05. Ttube is safe and effective in the treatment of SBAS. The severity of secretion retention increased in patients with long-term placement of the Ttube. For patients with mild stenosis and anatomical stenosis, the Ttube removal can be attempted at about 1 year of follow-up.
探讨 Montgomery T 硅胶支架（T 管）长期置入治疗声门下良性气道狭窄（SBAS）的并发症及 T 管成功取出的时机。我们回顾性收集了 32 例接受 T 管治疗的 SBAS 患者的临床资料，并分析了 T 管的置入和成功取出情况。患者中男 22 例，女 10 例，年龄 2179 岁，平均（60.9±13.7）岁。32 例患者 T 管均成功置入，其中 6 例（18.8%）轻度狭窄患者采用静脉全麻下置入。最长随访时间 60.4 个月，17 例（53.1%）T 管留置时间超过 12 个月；5 例（15.6%）因各种原因意外拔管后改行气管切开套管；9 例（28.1%）成功取出 T 管，T 管留置时间 5.222.7 个月，平均（12.1±6.3）个月，其中 9 例（100%）为解剖性狭窄。32 例患者均有分泌物潴留（100%），9 例（28.1%）有肉芽组织增生，大多数患者经支气管镜治疗和随访后不影响正常通气；3 例因严重并发症而取出 T 管。1 周、1 个月、3 个月、12 个月时分泌物潴留和肉芽组织增生的发生率差异无统计学意义（均 P>0.05）。T 管留置 12 个月以上患者 1 周、1 个月、3 个月、12 个月时分泌物潴留严重程度的差异有统计学意义（P<0.05），但肉芽组织增生严重程度的差异无统计学意义（P>0.05）。T 管治疗 SBAS 安全有效，长期留置 T 管患者分泌物潴留程度加重。对于轻度狭窄和解剖性狭窄患者，可尝试在随访 1 年左右拔管。
