Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Clinical Experience of Silicone Airway Stent in the Management of Benign Tracheobronchial Stenosis

양성 기도협착질환에서 실리콘 기도스텐트의 임상경험 - Dumon 스텐트와 Natural 스텐트의 비교 -

  • Ryu, Yon Ju (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center) ;
  • Yu, Chang-Min (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center) ;
  • Choi, Jae Chul (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center) ;
  • Kwon, Yong Soo (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center) ;
  • Kim, Hojoong (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center) ;
  • Kim, Jhingook (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center) ;
  • Suh, Soo Won (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center)
  • 류연주 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 유창민 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 최재철 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 권용수 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 김호중 (성균관대학교 의과대학 내과학교실, 삼성서울병원 호흡기내과) ;
  • 김진국 (성균관대학교 의과대학 흉부외과학교실, 삼성서울병원 흉부외과) ;
  • 서수원 (성균관대학교 의과대학 의공학교실, 삼성서울병원 의공학과)
  • Received : 2005.04.14
  • Accepted : 2005.07.07
  • Published : 2005.07.30
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Abstract

Background : The clinical results of a Natural stent in patients with a benign tracheobronchial stenosis were examined by comparing the clinical outcomes and complications of those patients who underwent Dumon and Natural stenting in the management of benign airway stenosis. Methods : The medical records of 94 patients (39 Dumon and 55 Natural stent) with a benign tracheobronchial stenosis were reviewed and analyzed. Results : Post-tuberculous stenosis was the leading indication for airway stenting (74%), which was followed by post-intubation stenosis (21%). After intervention, the dyspnea had improved among those patients who underwent Dumon (90%) and Natural (86%) stenting. After stabilizing the dyspnea, the stent could be successfully removed in half of the patients who underwent both Dumon (54%) and Natural (49%) stenting. During the 42 month follow-up period, the complication rate was similar in those patients who underwent Dumon and Natural stenting: migration (46% vs 53%), granulation tissue formation (36% vs 49%), mucostasis (21% vs 16%) and restenosis (51% vs 36%). Conclusion : The clinical results of Natural airway stent was similar to those of Dumon stent in the management of benign tracheobronchial stenosis.

연구배경 : 양성 기도협착질환 환자에서 새로 개발된 Natural 기도스텐트의 임상결과를 Dumon 스텐트와 비교하였다. 방 법 : 양성 기도협착으로 스텐트를 삽입한 94명의 환자 (39 Dumon, 55 Natural)를 대상으로 임상증상, 시술 전 검사결과, 시술방법, 그리고 추적관찰시의 임상경과를 후향적으로 조사하였다. 결 과: 원인질환으로 기관지결핵 후 기도협착 (74%)이 가장 많았고, 기관삽관 후 기관협착 (20명), 기관절개술 후 기관협착 (2명)등이 있었다. 스텐트를 삽입한 후, 전체 94명의 환자 중 82명 (87%)에서 주관적으로 호흡곤란이개선되었고, Dumon 스텐트군(35/39, 90%)과 Natural 스텐트군 (47/55, 86%) 사이의 차이는 없었다. 모두 48명 (51%)에서 중앙값 14개월(범위6-37개월)후에 스텐트를 성공적으로 제거할 수 있었고, Dumon 스텐트군 (54%, 16개월 후) 과 Natural 스텐트군 (49%, 12개월 후)간의 차이는 없었다. 스텐트 삽입 후 부작용은 스텐트의 위치 변동이 45명 (48%)에서, 육아종 과형성이 41명 (44%)에서, 점액저류에 의한 스텐트 내경 50% 이상의 감소가 17명 (18%)에서, 그리고 스텐트 삽입 전후부위의 협착이 40명 (43%)에서 발생하였다. Dumon 과 Natural 스텐트를 삽입한 환자들 사이에서 부작용의 분포의 차이는 없었다. 결 론 : 새로 개발한 Natural 기도스텐트는 양성기도협착 환자에서 기존의 Dumon 스텐트와 대등한 임상 결과를 보여주고 있어, 기도 협착이 있는 환자의 치료에 유용하게 사용할 수 있을 것으로 사료된다.

Keywords

Acknowledgement

Supported by : 보건복지부

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