Silva RA, Mesquita N, Nunes PP, Cardoso E, Pinto RM, Dias LM. Tracheobronchial Polyflex stents for the management of benign refractory hypopharyngeal strictures. World J Gastroenterol 2012; 18(6): 551-556 [DOI: 10.3748/wjg.v18.i6.551]
Corresponding Author of This Article
Rui Almeida Silva, MD, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal. rsgastro@sapo.pt
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World J Gastroenterol. Feb 14, 2012; 18(6): 551-556 Published online Feb 14, 2012. doi: 10.3748/wjg.v18.i6.551
Tracheobronchial Polyflex stents for the management of benign refractory hypopharyngeal strictures
Rui Almeida Silva, Nuno Mesquita, Pedro Pimentel Nunes, Elisabete Cardoso, Ricardo Marcos Pinto, Luís Moreira Dias
Rui Almeida Silva, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal
Nuno Mesquita, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal
Pedro Pimentel Nunes, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal
Elisabete Cardoso, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal
Ricardo Marcos Pinto, Department of Gastroenterology, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal
Luís Moreira Dias, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal
Author contributions: Silva RA conceived and designed the study; Silva RA, Mesquita N, Nunes PP and Pinto RM performed the research; Silva RA and Cardoso E analyzed and interpreted the data; Dias LM reviewed the article critically for important intellectual content; Silva RA wrote the article.
Correspondence to: Rui Almeida Silva, MD, Department of Gastroenterology, Instituto Português de Oncologia do Porto Francisco Gentil, R. Doutor António Bernardino de Almeida 4200-072, Porto, Portugal. rsgastro@sapo.pt
Telephone: +351-967057078 Fax: +351-225084055
Received: December 18, 2010 Revised: February 1, 2011 Accepted: February 8, 2011 Published online: February 14, 2012
Abstract
AIM: To describe a modified technique for placement of a tracheobronchial self-expanding plastic stent (SEPS) in patients with benign refractory hypopharyngeal strictures in order to improve dysphagia and allow stricture remodeling.
METHODS: A case series of four consecutive patients with complex hypopharyngeal strictures after combined therapy for laryngeal cancer, previously submitted to multiple sessions of dilation without lasting improvement, is presented. All patients underwent placement of a small diameter and unflared tracheobronchial SEPS. Main outcome measurements were improvement of dysphagia and avoiding of repeated dilation.
RESULTS: The modified introducer system allowed an easy and technically successful deployment of the tracheobronchial Polyflex stent through the stricture. All four patients developed complications related to stent placement. Two patients had stent migration (one proximal and one distal), two patients developed phanryngocutaneous fistulas and all patients with stents in situ for more than 8 wk had hyperplastic tissue growth at the upper end of the stent. Stricture recurrence was observed at 4 wk follow-up after stent removal in all patients
CONCLUSION: Although technically feasible, placement of a tracheobronchial SEPS is associated with a high risk of complications. Small diameter stents must be kept in place for longer than 3 mo to allow adequate time for stricture remodeling.
