10.6084/m9.figshare.4476239.v1
Mehta R.M.
Mehta
R.M.
Singla A.
Singla
A.
Shah A.
Shah
A.
Loknath C.
Loknath
C.
Supplementary Material for: The “Hitch Stitch”: An Effective Method of Preventing Migration in High Tracheal Stenosis
Karger Publishers
2016
Adolescents
Young adults
Middle-aged people
Bronchoscopy
Tracheal stenosis
Retrospective studies
Silicone stents
Prosthesis migration
Suture techniques
Foreign-body migration, prevention and control
2016-12-16 11:22:08
Media
https://karger.figshare.com/articles/media/Supplementary_Material_for_The_Hitch_Stitch_An_Effective_Method_of_Preventing_Migration_in_High_Tracheal_Stenosis/4476239
<p><b><i>Background:</i></b> The incidence of caudal stent migration in
high tracheal stenting is 13-21% and is common with silicone stents.
This can lead to major problems, including emergency repeat procedures.
Several antimigration methods are described, but have limitations in
terms of their success rate, availability, cost or ease of the
procedure. <b><i>Objectives:</i></b> We describe an innovative method of
stent migration prevention using a simple percutaneous anchoring “hitch
stitch”, validated in a large series. <b><i>Methods:</i></b> After
tracheal stent placement, an Ethilon suture was passed into the stent
lumen through an 18-G needle. To take this suture back to the exterior
to complete the stitch, a retrieval loop was passed through another 14-G
percutaneous cannula inserted into the stent lumen. Bronchoscopically,
using a forceps the first suture was pulled inside the loop, the loop
was retracted, the suture was exteriorized, and the knot was completed
and embedded subcutaneously. While removing the stent, an endoscopic
scissor was used to cut the stitch to free the stent. <b><i>Results:</i></b>
A total of 42 “hitch stitches” were done in 29 patients over 5 years,
predominantly for silicone stents. Indications for stenting included
postintubation tracheal stenosis (83.3%), malignancy (11.9%) and
tracheoesophageal fistula (4.8%, metal stents). The procedure was
successful in 41/42 (97.6%) patients. Stitch removal was uncomplicated. <b><i>Conclusion:</i></b>
This is the largest series of an external stent anchoring procedure as a
migration prevention strategy in high tracheal stenting, applicable to
both silicone and metal stents. Stent migration prevention using this
“hitch stitch” is simple, safe and successful, without any complications
during stent removal.</p>