Analyzing The Causes Of 386 Patients With Benign Central Airway Stenoses And Evaluating The Efficacy Of Endoscopic Interventional Treatments

PURPOSE: To find the causes of benign central airway stenoses and evaluate the efficacy of endoscopic interventional treatments.MATERIALS AND METHODS: 386 outpatients and inpatients with benign central airway stenoses in our hospital were analysed for this retrospective study from January 1999 to December 2006.We reviewed patient records and bronchoscopic findings.The causes of benign central airway stenoses were analysed.We employed interventional treatments through flexible bronchoscopy to treat benign central airway stenoses.The endoscopic interventional treatments include: laser,electrocautery,argon plasma coagulation (APC),cryotherapy, balloon dilation (BD) and stent insertion. In order to evaluate the endoscopic interventional treatments,airway diameters,FEV1 and dyspnea index were evaluated before the procedure and immediately after the last operation.RESULTS:1.Demographical Characteristics: 386 outpatients and inpatients with benign central airway stenoses in our hospital received the endoscopic treatments from January 1999 to December 2006. There were 227 females and 109 males,with a mean (SD) age of (33士17)years (range,16-76years). The male to female ratio was 1:2.54.2. Lesion locus: The lesions were located in the trachea in 68 cases, left main bronchus in 154 cases,right main bronchus in 48 cases,right-middle lobarb bronchus in 37 cases,trachea and left main bronchus in 43 cases,trachea and right main bronchus in 21 cases,all in 15 cases.3. Etiology:The causes of benign central airway stenoses were as followed: Caused by tracheobronchial tuberculosis in 248 (64.3%),secondary to prolonged orotracheal intubation or tracheotomy in 58 (15.0%),tracheobronchial injury in 14 (3.63%),inhaling burn in 12 (3.11%), tracheobronchial bengin tumour in 11 (2.85%),relapsing polychondritis in 8 (2.07%),post-radiotherapy in 7 (1.81%), obstructive tracheobronchial aspergillosis in 5 (1.30% ),silicosis in 5 (1.30%), sarcoidosis in 4 (1.04%),tracheobronchial amyloidosis in 4(1.04%), anastomotic stricture in 4 (1.04%), tracheobronchopathia osteochondroplasticain 3 (0.78%), airway foreign body in 3 (0.78%).The most common causes of benign central airway stenoses is tracheobronchial tuberculosis,secondary to prolonged orotracheal intubation or tracheotomy.4.The endoscopic treatments:Over the study period,754 therapeutic procedures were performed.The endoscopic interventional treatments were performed as followed:11 lasers,26 argon plasma coagulations,92 cryotherapys,249 balloon dilatations,237 electrocauterizations and 139 stent insertions.26 patients only received one endoscopic treatment,central airway patency was achieved.Others must received further united endoscopic interventional treatments.5.The changes of average airway diameters,FEV1 and dyspnea index:Airway diameters,FEV1 and dyspnea index were evaluated before the procedure and immediately after the last operation.The average airway diameters increased from (2.49±1.57) mm to (6.41±1.70) mm ( P < 0.01). FEV1 increased from(2.11±0.60) L to (3.46±0.75) L ( P < 0.01).Dyspnea index decreased from 2.40±0.79 to (0.64±0.50) ( P < 0.01) .6.Efficacy:Employing interventional treatments through flexible bronchoscopy to treat benign central airway stenoses is efficitive during the short-time period. Symptom such as cough and dyspnea improvement was observed immediately in 89.9% (347/ 386) of all patients.Most patients had stenoses recurrence.keeping long-term efficacy requires to united endoscopic interventional treatments. 65.5% (253/ 386)central airway patency was achieved.CONCLUSION: The most common causes of benign central airway stenoses is tracheobronchial tuberculosis. Employing interventional treatments through flexible bronchoscopy to treat benign central airway stenoses is efficitive during the short-time period,keeping long-term efficacy requires to further united endoscopic interventional treatments.