Xie Zhibo, Chen Jiarui, Zheng Yangyang, Li Xiaoyan
Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, 355 Luding Road, Shanghai, 200062, China.
Eur Arch Otorhinolaryngol. 2025 Sep 11. doi: 10.1007/s00405-025-09654-9.
Laryngotracheal stenosis (LTS) is one of the most common causes of pediatric airway obstruction. Patients with LTS who receive multiple treatments but still fail to achieve decannulation are defined as having refractory LTS. Treatments for these patients are especially complicated and unsatisfactory. Biodegradable drug-coated stents (BDCSs) have the advantages of providing stable airway support, not requiring a second operation for removal, and preventing restenosis via the slow-release of a coated drug. We aimed to explore the role of BDCSs in treating refractory LTS.
This study enrolled patients with refractory LTS who had undergone previous unsuccessful treatments between 2017 and 2023. Patients were divided into two groups on the basis of whether they received BDCS treatment (BDCS group, n = 30; non-BDCS group, n = 59). Success was defined as achieving decannulation.
Among the 89 patients with refractory LTS, 66 patients (74.1%) eventually achieved decannulation. The decannulation rate was significantly greater in the BDCS group (P = 0.020). In patients who achieved decannulation, BDCSs significantly reduced the overall duration (P = 0.044) and total number of interventions (P = 0.029). We observed that 12 patients showed improvement in stenosis within one month after the postoperative follow-up, and those with a BDCS had a greater improvement rate (P = 0.047).
BDCSs could be a promising option for patients with severe refractory LTS.
喉气管狭窄（LTS）是小儿气道梗阻最常见的原因之一。接受多次治疗但仍未能实现拔管的LTS患者被定义为难治性LTS。这些患者的治疗特别复杂且效果不佳。可生物降解药物涂层支架（BDCS）具有提供稳定气道支撑、无需二次手术取出以及通过涂层药物缓释防止再狭窄的优点。我们旨在探讨BDCS在治疗难治性LTS中的作用。
本研究纳入了2017年至2023年间曾接受过不成功治疗的难治性LTS患者。根据患者是否接受BDCS治疗将其分为两组（BDCS组，n = 30；非BDCS组，n = 59）。成功定义为实现拔管。
在89例难治性LTS患者中，66例（74.1%）最终实现了拔管。BDCS组的拔管率显著更高（P = 0.020）。在实现拔管的患者中，BDCS显著缩短了总疗程（P = 0.044）和干预总次数（P = 0.029）。我们观察到12例患者在术后随访1个月内狭窄情况有所改善，且使用BDCS的患者改善率更高（P = 0.047）。
对于严重难治性LTS患者，BDCS可能是一种有前景的选择。
