Abstract

Post-intubation tracheal stenosis (PITS) causes severe morbidity. COVID-19 pandemic dramatically increased ICU hospitalizations and incidence of tracheal stenosis posing noveltreatment challenges. Surgery in operable patients is still the treatment of choice. However, in cases not amenable to or relapsing after surgery, bronchoscopic management for dilatationand stent placement is warranted. In benign tracheal strictures, cylindrical silicone stents are used although sometimes they lack firm contact with narrow and irregular airway walls, resulting in several complications. An ?hourglass? shaped tracheal stent has been developed for better appositioning to the airway wall in annular stenosis.

We aimed to compare the effectiveness and the rate of complications using these two types ofstents in patients with PITS.

We studied 54 cases of stent placement (28 straight stents and 26 hourglass stents) in 47 patients referred to our IP Unit between 2009 and 2022. The rate of the complications and their severity, number of bronchoscopies, and outcomes were retrospectively collected. Both stents showed similar results in terms of the rate and severity of complications, number of bronchoscopies needed and patients? compliance. There was a statistically significant difference though (p=0.019) in favour of the hourglass stents group regarding the successful outcome defined as definitive treatment.

Hourglass shaped stents represent an additional treatment option for PITS with easier application in stenotic and irregular airways while being non-inferior to straight stents in terms of complications and tend to attain better final outcomes. These results need to be confirmed by further studies and longer follow-up of patients.