Benign stenoses of the large airways. Campariosn of two patients simples from years 1998/2003 and 2014-2016
Abstract
Benign stenoses (BS) of the large airways are a persistent clinical problem; the opinions on their treatment are varied. To find out how the management of BS was changing, two patient samples from the years 1998-2003 (n = 80) and 2014-2016 (n = 54) were compared.
There were no changes in composition of the samples with regard to the most common cause, namely intubation or tracheostomy (77 % and 87 %). Similarly, there was no difference in the time interval from the cause to diagnosis of BS which was two to three months.
By contrast, the age of patients increased significantly from 54 to 64 years and the proportion of patients undergoing surgery dropped significantly from 47 % to 26 %. The effect of bronchoscopic treatment was similar; patients in the first sample were significantly less frequently stented (27 % vs. 53 %).
Stent-related complications were observed in 23 % and 41 % of patients in the two samples; the other interventional bronchoscopy procedures were only rarely accompanied by complications. We do not change the recommended algorithm of care for these patients, as developed by our team and published in Respiration in 2005, and still consider surgery as the gold standard in the treatment of BS.
In patients unable to undergo surgery, interventional bronchoscopy is an effective approach to BS therapy. The last part of the article summarizes available information on the development, diagnosis and treatment of BS of the large airways