A comparative study of interventional bronchoscopy in treatment of central airway stenosis after tracheal intubation and tracheotomy

Objective To explore the best interventional treatment for patients with central airway stenosis after tracheal intubation and tracheotomy. Methods Seventy-nine patients with central airway stenosis after tracheal intubation or tracheotomy were divided into four groups, group A was treated with balloon dilation alone, group B was treated with balloon dilation and freezing, group C was treated with needle-shaped electric knife and balloon dilation, group D was treated with balloon dilation and topical application of mitomycin for injection.Each patient was treated with interventional therapy once a week, and the total treatment duration was four weeks.The efficacy was evaluated at the 5th, 9th, 13th, 21st, 25th, and 29th week after the first treatment. Results Compared with before treatment, the dyspnea score, KPS and the degree of stenosis were significantly improved in all patients after treatment, and the efficiency and clinical benefit rate of the four groups were above 85%.The cross-sectional area of narrowest section was the largest in the first curative effect evaluation.Subsequently, the lumen was partly retracted, but overall was still significantly expanded, which lasted for more than half a year, there was no significant difference among the four groups.All patients had no serious adverse events during and after treatment. Conclusions The above methods can be effectively used to treat central airway stenosis after tracheal intubation or tracheotomy.In order to simplify the treatment program and lower the cost of treatment, it is recommend the use of balloon dilation alone for the treatment of central airway stenosis after tracheal intubation or tracheotomy among the four methods mentioned above. Key words: Central airway stenosis; Tracheal intubation; Tracheotomy; Bronchoscopy; Interventional therapy