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The management of bronchus intermedius complications after lung transplantation: a retrospective study.

Lari SM, Gonin F, Colchen A - J Cardiothorac Surg (2012)

Bottom Line: The Montgomery T-tube number 10 was used in 9 patients (75%).There was statistically significant difference in Forced Expiratory Volume in one second (FEV1) before and after stent placement (p = 0.01).The most common complication after stent placement was migration (33%).

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Affiliation: Lung Disease and Tuberculosis Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. larish@mums.ac.ir

ABSTRACT

Background: Airway complications following lung transplantation remain a significant cause of morbidity and mortality. The management of bronchial complications in Bronchus Intermedius (BI) is challenging due to the location of right upper bronchus. The aim of this study was to analyze the results of BI Montgomery T-tube stent in a consecutive patients with lung transplantations.

Methods: Between January 2007 and December 2010, 132 lung transplantations were performed at Foch Hospital, Suresnes, France. All the patients who had BI Montgomery T-tube after lung transplantation were included in this retrospective study. The demographic and interventional data and also complications were recorded.

Results: Out of 132 lung transplant recipients, 12 patients (9 male and 3 female) were entered into this study. The indications for lung transplantation were: cystic fibrosis 8 (67%), emphysema 3 (25%), and idiopathic pulmonary fibrosis 1 (8%). Most of the patients (83%) had bilateral lung transplantation. The mean interval between lung transplantation and interventional bronchoscopy was 11.5 ± 9.8 (SD) months. There was bronchial stenosis at the level of BI in 7 patients (58.3%). The Montgomery T-tube number 10 was used in 9 patients (75%). There was statistically significant difference in Forced Expiratory Volume in one second (FEV1) before and after stent placement (p = 0.01). The most common complication after stent placement was migration (33%).

Conclusion: BI complications after lung transplantation are still a significant problem. Stenosis or malacia following lung transplantation could be well managed with modified Montgomery T-tube.

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Introduction of T-tube in right main bronchus.
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Figure 2: Introduction of T-tube in right main bronchus.

Mentions: In the case of airway complications including stenosis, malacia, or obstructive necrotic tissues, rigid bronchoscopy (KARL STORZ, Germany) was applied. It was performed under general anesthesia and jet ventilation. Depending on the pathological finding, the suitable interventions including mechanical dilatation, laser, and cryotherapy were performed. The dilatation was used when there was a significant decline in forced expiratory volume in one second (FEV1) with no other etiology or narrowing of the airway > 50% of predicted diameter. Additionally, the Montgomery T-tube with appropriate size was inserted when there was significant stenosis or malacia (Figure 2, 3) but not necessarily after the first dilatation.


The management of bronchus intermedius complications after lung transplantation: a retrospective study.

Lari SM, Gonin F, Colchen A - J Cardiothorac Surg (2012)

Introduction of T-tube in right main bronchus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3275502&req=5

Figure 2: Introduction of T-tube in right main bronchus.
Mentions: In the case of airway complications including stenosis, malacia, or obstructive necrotic tissues, rigid bronchoscopy (KARL STORZ, Germany) was applied. It was performed under general anesthesia and jet ventilation. Depending on the pathological finding, the suitable interventions including mechanical dilatation, laser, and cryotherapy were performed. The dilatation was used when there was a significant decline in forced expiratory volume in one second (FEV1) with no other etiology or narrowing of the airway > 50% of predicted diameter. Additionally, the Montgomery T-tube with appropriate size was inserted when there was significant stenosis or malacia (Figure 2, 3) but not necessarily after the first dilatation.

Bottom Line: The Montgomery T-tube number 10 was used in 9 patients (75%).There was statistically significant difference in Forced Expiratory Volume in one second (FEV1) before and after stent placement (p = 0.01).The most common complication after stent placement was migration (33%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Lung Disease and Tuberculosis Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. larish@mums.ac.ir

ABSTRACT

Background: Airway complications following lung transplantation remain a significant cause of morbidity and mortality. The management of bronchial complications in Bronchus Intermedius (BI) is challenging due to the location of right upper bronchus. The aim of this study was to analyze the results of BI Montgomery T-tube stent in a consecutive patients with lung transplantations.

Methods: Between January 2007 and December 2010, 132 lung transplantations were performed at Foch Hospital, Suresnes, France. All the patients who had BI Montgomery T-tube after lung transplantation were included in this retrospective study. The demographic and interventional data and also complications were recorded.

Results: Out of 132 lung transplant recipients, 12 patients (9 male and 3 female) were entered into this study. The indications for lung transplantation were: cystic fibrosis 8 (67%), emphysema 3 (25%), and idiopathic pulmonary fibrosis 1 (8%). Most of the patients (83%) had bilateral lung transplantation. The mean interval between lung transplantation and interventional bronchoscopy was 11.5 ± 9.8 (SD) months. There was bronchial stenosis at the level of BI in 7 patients (58.3%). The Montgomery T-tube number 10 was used in 9 patients (75%). There was statistically significant difference in Forced Expiratory Volume in one second (FEV1) before and after stent placement (p = 0.01). The most common complication after stent placement was migration (33%).

Conclusion: BI complications after lung transplantation are still a significant problem. Stenosis or malacia following lung transplantation could be well managed with modified Montgomery T-tube.

Show MeSH
Related in: MedlinePlus