Prognostic Factors for Tracheal Restenosis after Stent Removal in Patients with Post-Intubation and Post-Tracheostomy Tracheal Stenosis
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Purpose: Long-term tracheal stent placement can increase the risk of stent-related complications; hence, removal of the stent afterstabilization is attempted. However, little evidence has been established regarding the risk factors for tracheal restenosis. Weaimed to identify the risk factors for tracheal restenosis in patients with post-intubation tracheal stenosis (PITS) and post-tracheostomytracheal stenosis (PTTS). Materials and Methods: We retrospectively analyzed patients with PITS and PTTS between January 2004 and December 2019. Patients were classified into a success or failure group according to treatment outcomes. Patients with successful stent removalwere defined as patients who did not require additional intervention after stent removal during the follow-up period. Multiple logisticregression analysis was performed to identify the factors associated with tracheal restenosis. Results: Among 269 stented patients, 130 patients who had removed the stent were enrolled in this study. During the follow-upperiod, 73 (56.2%) patients had a stable clinical course; however, 57 (43.8%) patients had restenosis. The proportion of trauma-inducedintubation was higher in the success group than in the failure group (p=0.026), and the median stent length was shorter inthe success group (45 mm) than in the failure group (50 mm, p=0.001). On multivariate analysis, trauma-induced intubation [adjustedodds ratio (aOR), 0.329; 95% confidence interval (CI), 0.117–0.927; p=0.036], and stent length <50 mm (aOR, 0.274; 95% CI,0.130–0.578; p=0.001) were associated with a decreased risk of restenosis. Conclusion: Trauma-induced intubation and stent length were associated with successful stent removal.
Abstract
Purpose: Long-term tracheal stent placement can increase the risk of stent-related complications; hence, removal of the stent afterstabilization is attempted. However, little evidence has been established regarding the risk factors for tracheal restenosis. Weaimed to identify the risk factors for tracheal restenosis in patients with post-intubation tracheal stenosis (PITS) and post-tracheostomytracheal stenosis (PTTS). Materials and Methods: We retrospectively analyzed patients with PITS and PTTS between January 2004 and December 2019. Patients were classified into a success or failure group according to treatment outcomes. Patients with successful stent removalwere defined as patients who did not require additional intervention after stent removal during the follow-up period. Multiple logisticregression analysis was performed to identify the factors associated with tracheal restenosis. Results: Among 269 stented patients, 130 patients who had removed the stent were enrolled in this study. During the follow-upperiod, 73 (56.2%) patients had a stable clinical course; however, 57 (43.8%) patients had restenosis. The proportion of trauma-inducedintubation was higher in the success group than in the failure group (p=0.026), and the median stent length was shorter inthe success group (45 mm) than in the failure group (50 mm, p=0.001). On multivariate analysis, trauma-induced intubation [adjustedodds ratio (aOR), 0.329; 95% confidence interval (CI), 0.117–0.927; p=0.036], and stent length <50 mm (aOR, 0.274; 95% CI,0.130–0.578; p=0.001) were associated with a decreased risk of restenosis. Conclusion: Trauma-induced intubation and stent length were associated with successful stent removal.
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