Utility of rigid bronchoscopic dilatation and mitomycin C application in the management of postintubation tracheal stenosis: case series and systematic review of literature

J Bronchology Interv Pulmonol. 2012 Oct;19(4):304-10. doi: 10.1097/LBR.0b013e3182721290.

Abstract

Background: Postintubation tracheal stenosis (PITS) is a common problem encountered by interventional pulmonologists. The aim of this study was to evaluate the utility of mitomycin C (MMC) as an adjunctive treatment to rigid bronchoscopic dilatation in patients with PITS.

Methods: Prospective analysis of data from the interventional pulmonology unit of a large tertiary care teaching center in North India. Patients with a diagnosis of PITS undergoing rigid bronchoscopic dilatation and MMC (0.4 mg/mL) application were included. The primary outcome was the occurrence of restenosis.

Results: Seven patients underwent rigid bronchoscopic dilatation, followed by the application of MMC at 4 quadrants of the stenosis. Controlled radial expansion balloon bronchoplasty was also performed, if necessary, in addition to mechanical dilatation using the barrel of the rigid bronchoscope. Restenosis occurred in all 7 patients (100%) and the mean duration to the detection of restenosis was 27 days. The restenosis was symptomatic in 6 out of 7 (85.7%) patients.

Conclusions: Rigid bronchoscopic dilatation and a single application of MMC is not an effective treatment in the management of PITS.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Airway Extubation / adverse effects
  • Bronchoscopy / methods*
  • Combined Modality Therapy
  • Dilatation / methods*
  • Female
  • Humans
  • Intubation, Intratracheal / adverse effects*
  • Male
  • Mitomycin / administration & dosage*
  • Prospective Studies
  • Respiratory System Agents / administration & dosage*
  • Secondary Prevention
  • Tracheal Stenosis / therapy*
  • Young Adult

Substances

  • Respiratory System Agents
  • Mitomycin