Silicone Stent Research Articles

MP42-11 SILICONE STENTING FOR CHRONIC URETERAL OBSTRUCTION IMPROVES STENT EXCHANGE FREQUENCY

You have accessJournal of UrologyCME1 Apr 2023MP42-11 SILICONE STENTING FOR CHRONIC URETERAL OBSTRUCTION IMPROVES STENT EXCHANGE FREQUENCY Bebe Eke and Suwaee, Ga Noah Canvasser Bebe EkeBebe Eke More articles by this author and Suwaee, Ga Noah CanvasserSuwaee, Ga Noah Canvasser More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003280.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chronic ureter stenting is recommended for patients with malignant ureteral obstruction, or with benign ureteral obstruction but cannot tolerate or do not want definitive surgical management. Stents are exchanged at time intervals often limited by stent encrustation; prior in vitro studies have demonstrated that silicone stents have less encrustation. Our objective was to compare patients undergoing chronic exchanges with polymer-based and silicone stents. METHODS: This IRB-approved retrospective study included all adult patients who underwent chronic ureter stent exchange from August 2017 through August 2022. Patients were stented with either a Boston Scientific PercuflexTM Plus or a Cook Black Silicone stent. Demographics, dates of exchange, stent type and size, and the presence of external and luminal encrustation were captured from operative reports. A subset of patients with >8F stents was analyzed given larger stents have lower rates of encrustation. Students t-test and chi-squared analysis were used to compare polymer-based vs silicone stents. RESULTS: In total, 52 patients underwent 165 stent exchanges: 72% were polymer-based (n=119), 28% were silicone (n=44), and 1% were metallic (n=2, excluded). Table 1 lists patient demographics and stent sizes. Mean exchange interval for silicone stents was significantly longer than for polymer-based stents (197±60 vs 139±87 days, p<0.0001). Despite this, there was no significant difference in external encrustation (9 vs 18%, p=0.18) or luminal encrustation (7% vs 4%, p=0.49). Sub-group comparison of stents >8F also showed longer exchange interval (191±40 vs 106±36 days, p<0.0001), similar external encrustation (10.3 vs 24%, p=0.13), and similar luminal encrustation (6.9 vs 5.6%, p=0.82). CONCLUSIONS: Utilizing silicone stents for chronic ureter stent exchanges significantly increases the exchange interval due to lower encrustation rates over similar time periods compared to a polymer-based stent. Further work with other polymer-based and silicone stents is warranted to evaluate the generalizability of these results. Source of Funding: COI: Consultant for Boston Scientific and Cook Medical, this study is unfunded © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e571 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bebe Eke More articles by this author Suwaee, Ga Noah Canvasser More articles by this author Expand All Advertisement PDF downloadLoading ...

Different Modalities for Management of Pediatric Epiphora.

This study assessed the efficacy and safety of different modalities for managing nasolacrimal duct obstruction and epiphora in children over one year. We performed a non-randomized prospective study on 98 children (149 eyes) with epiphora and no history of lacrimal operation. The selected candidates attended the ENT and ophthalmology outpatient clinics of Minia University Hospital, seeking to treat epiphora that may or may not be associated with sinonasal pathology. Nasolacrimal operations involved a joint approach involving an otorhinolaryngologist and an ophthalmologist. Ninety-eight children (149 eyes) were identified. Ages varied from 1 to 12 years old. Conservative measures were successful in 32.6% of children. Silicone stents were used in 27.5% of the interventions with a mean time to removal of 3-6 months. The success rate for dacryocystorhinostomy (DCR) was 85.7%. Revision surgery was performed in 10% of probing cases, 8% of intubation cases, and 14.3% of DCR patients. The concomitant chronic sinonasal problems were evident in 62.2% of patients. Conservative measures, probing, endonasal nasolacrimal intubation, endoscopic DCR, and external DCR are safe and effective procedures forepiphora in children. Also, correcting concomitant nasopharyngeal or sinonasal diseases in epiphora patients is crucial for successful management, overcoming recurrence, and minimizing morbidity.

A 3D-engineered silicone stent to treat a refractory bronchopleural fistula.

A novel 3D-engineered silicone stent was successfully used to treat a refractory bronchopleural fistula of the right lower lobe in a patient with an open-window thoracostomy who complained of severe dysphonia and recurrent infections https://bit.ly/3GrKs2p.

A Novel Snake-chain Metal Probed Silicon Intubation Set for Nasolacrimal Duct Intubation: A Cadaveric Feasibility Study.

A fresh-frozen human cadaveric feasibility study to investigate the feasibility of probing and stenting the nasolacrimal ducts (NLDs) of human cadavers with a novel flexible bicanalicular nasolacrimal stent. A custom-designed bicanalicular nasolacrimal stent was made by connecting a 250 mm long, 0.9 mm diameter silicone tube to a 200 mm long stainless-steel, snake-chain probe at each end. The punctum was dilated, and the snake-chain stent fed into the nasolacrimal drainage system. The emergence of the stents from the terminal end of the NLD and retrieval with a ball probe was conducted under endoscopic guidance. Bicanalicular nasolacrimal stenting with intranasal retrieval under endoscopic guidance was successfully achieved in six NLDs of three adult cadaveric nasolacrimal drainage systems. Despite being soft and flexible, the snake-chain silicon stent passes smoothly and freely through cadaveric human NLD and is easily retrieved from the nasal cavity. This novel NLD stent design may make stenting of the NLD easier and less traumatic.

Endogenous Interleukin-10 Contributes to Wound Healing and Regulates Tissue Repair

IntroductionInterleukin-10 (IL-10) is essential in fetal regenerative wound healing and likewise promotes a regenerative phenotype in adult dermal wounds. However, the role of endogenous IL-10 in postnatal dermal wound healing is not well-established. We sought to determine the function of endogenous IL-10 in murine full thickness excisional wounds that are splinted to prevent contracture and mimic human patterns of wound closure. MethodsFull-thickness excisional wounds were made in wildtype (WT) and IL-10−/− mice on a C57BL/6J background (F/M, 8 wk old). In a subset of wounds, contraction was prevented by splinting with silicone stents (stenting) and maintaining a moist wound microenvironment using a semiocclusive dressing. Wounds were examined for re-epithelialization, granulation tissue deposition, and inflammatory cell infiltrate at day 7 and fibrosis and scarring at day 30 postwounding. ResultsWe observed no difference in wound healing rate between WT and IL-10−/− mice in either the stented or unstented group. At day 7, unstented IL-10−/− wounds had a larger granulation tissue area and more inflammatory infiltrate than their WT counterparts. However, we did observe more F4/80+ cell infiltrate in stented IL-10−/− wounds at day 7. At day 30, stented wounds had increased scar area and epithelial thickness compared to unstented wounds. ConclusionsThese data suggest that endogenous IL-10 expression does not alter closure of full thickness excisional wounds when wound hydration and excessive contraction of murine skin are controlled. However, the loss of IL-10 leads to increased inflammatory cell infiltration and scarring. These new findings suggest that IL-10 contributes to the regulation of inflammation without compromising the healing response. These data combined with previous reports of increased rates of healing in IL-10−/− mice wounds not controlled for hydration and contraction suggest an important role for murine wound healing models used in research studies of molecular mechanisms that regulate healing.

Endonasal Dacryocystorhinostomy: Results With or Without Stenting.

Introduction This is a comparative cross-sectional study done to compare the curative outcome of endonasal dacryocystorhinostomy (DCR) done with and without a silicon stent in patients with chronic dacryocystitis due to nasolacrimal duct obstruction. Methods This study was carried out in central India, involving 60 patients who were diagnosed with chronic dacryocystitis and underwent endonasal DCR (with zero-degree and 45-degree endoscopes from Olympus, with an Olympus camera and monitor) between October 2021 and September 2022. All patients were over the age of 18, with major exclusion criteria of previous DCRand sinonasal disease. All the surgeries were done by the same senior surgeon, in which 30 patients were stented (with a Prison silicone nasolacrimal duct stent) and 30 of them were non-stented. The follow-up duration for these was 12 months after the surgery. Results The outcome was evaluated at the end of three months, six months, and 12 months for both groups (patients with and without stents) using the Chi-square test. The success rate at the end of six months was 90% with stented patients and 93.3% with non-stented patients (p-value - 0.64); at six months, it was also the same (p-value - 0.64); and at the end of 12 months, it was 80% and 76.6% (p-value - 0.71) for patients with and without a stent, respectively. The final endoscopy at the end of 12 months showed 93.3% of patients who underwent stenting had a patent rhinostomy opening, and 90% of those who were not stented had a patent opening. Conclusions Our observational comparative study showed that patients with chronic dacryocystitis who underwent endonasal DCR with and without stenting had almost similar results. There was no significant difference in the outcome. So, we concluded that generally all the patients should be considered for endonasal DCR without a stent, except in special cases like revision endonasal DCR, lacrimal gland cysts, fistulas, and patients with sinonasal pathology, in whom silicon stents can be preferred.

Silicone stent placement using a rigid bronchoscope via a tracheostoma in a patient with postpneumonectomy syndrome

BackgroundSilicone stents are options for airway stenosis or obstruction. Generally, silicone stent placement needs rigid bronchoscopy, but manipulation of a rigid bronchoscope has technical difficulties in some cases. The objective of this clinical case report is to highlight silicone stent placement with a rigid bronchoscope successfully achieved by changing the insertion from the mouth to the tracheostoma in a patient with postpneumonectomy syndrome.Case presentationA 47-year-old man underwent right-side pneumonectomy 30 years previously, and he had an intubation tube inserted through a tracheostoma for 29 years to maintain the lumen for bronchial stenosis due to postpneumonectomy syndrome. A granuloma grew at the distal end of intubation tube, and he had labored breathing with stridor. Rigid bronchoscopy for silicone stent placement via the mouth failed because of airway curvature. We sequentially tried rigid bronchoscopy via the tracheostoma as an alternative, and we could easily insert the scope into the left secondary carina and place the silicone stent.ConclusionAlthough strong airway curvature with tracheostomy is an uncommon situation, we succeeded silicone stent placement using a rigid bronchoscope via the tracheostoma. Insertion of a rigid bronchoscope via the tracheostoma instead of via the mouth could be an option.

A Comparative Study of Surgical Outcome in Endoscopic Endonasal Dacrocystorhinostomy with and without Stenting

Introduction To remove tears from people’s eyes’ – is one of the greatest challenges of lacrimal surgery. Epiphora is defined as watering eye due to inadequate drainage of normally produced tears. Dacryocystitis is the inflammation of the lacrimal drainage system which presents as acute dacryocystitis or a much commonly as chronic dacryocystitis. Other common causes of ephiphora are blepharitis, conjunctivitis, trichiasis, punctal eversion and foreign bodies. The conventional treatment for watering eyes due to Naso Lacrimal Duct (NLD) is the procedure of external dacryocystorhinostomy (DCR) which has its own limitations and disadvantages. With the introduction of high resolution endoscopes for paranasal sinuses, endoscopic endonasal DCR (EnDCR) is gaining popularity. The main advantages of the endoscopic technique are minimal morbidity, less intraoperative bleed, shorter operative time, preservation of pump function of orbicularis occuli muscle, presaccal fibers and medial canthal tendon and avoidance of cutaneous scar. In EnDCR the most common cause for failure of surgery is closure of rhinostoma and to prevent this silicone tube insertion is the most preferred method. It has also been claimed that silicone tubing would improve surgical results. But studies also indicate that silicone tubing itself results in certain problems like, foreign body sensation, increased granulation tissue leading to failure, prolapse of tube leading to injury to cornea, nasal migration of tube, fistula formation, pharyngitis and associated sinusitis &amp; recurrent nose bleed. The present study was undertaken to compare the surgical results of endoscopic endonasal DCR with and without silicone stent. Aims &amp; Objectives To compare the success rates of endonasal dacryocystorhinostomy and evaluate the presence of post-operative changes and their effect on the outcome of the surgery in endoscopic dacryocystorhinostomy with and without stenting. Material &amp; Methods This Prospective randomized comparative study was carried out amongst the patients attending department of ENT and referred cases from ophthalmology department for chronic nasolacrimal duct obstruction, both as inpatients and outpatients with complaint of chronic epiphora. 50 patients divided into two groups of 25 each fulfilling inclusion and exclusion criteria were included using convenient sampling. Participants were divided into two groups of 25 each based on randomization technique. Group 1 includes patients undergoing EnDCR with stenting and Group 2 includes patients undergoing EnDCR without stenting. Patients were assessed for post-operative complications like granulations, size of the neo ostium and patency of the neo ostium were assessed on nasal endoscopy. Data was entered in MS Excel work sheet. Data was analyzed using appropriate statistical methods. Result This study had Female predominance in both the groups. No predominance for any side was observed. No major intra operative complications were observed. Duration of surgery was more in Group I which was statistically significant. Post-operative complications are seen more in group without stenting (64.0%) than in group with stenting (56%) with no statistical difference between the two groups. Granulations had no effect on the outcome of the. On subjective assessment of symptoms 92% of patients in group I and 88% of patients in group II showed improvement of symptoms post operatively. No statistical difference had been found between the results of both the groups. On objective assessment of size of the neo ostium, no statistical difference was seen between the two groups. The size of the neo ostium had no effect on the outcome of the surgery. On objective assessment of patency of the neo ostium was observed in 92% of patients in group I and 88% patients in group II with no statistical difference between the two groups. Conclusion As success rates of the surgery with stenting and without stenting are comparable and

Clinical Factors for Successful Removal of Airway Silicone Stents in Patients With Post-Tuberculosis Tracheobronchial Stenosis.

After relieving stenosis with an airway silicone stent in post-tuberculosis bronchial stenosis (PTTS), stent removal is attempted if it is determined that airway patency can be maintained even after stent removal. However, the factors affecting airway stent removal are not well known. We investigate the factors that enable the successful removal of airway silicone stents in patients with PTTS. We retrospectively analyzed PTTS patients who underwent bronchoscopic intervention from January 2004 to December 2019. Successful stent removal is defined as airway patency maintained when the stent is removed, so that reinsertion of the stent is not required. A multivariate logistic regression analysis was used to identify independent factors associated with successful stent removal at the first attempt. Total 344 patients were analyzed. Patients were followed up for a median of 47.9 (26.9-85.2) months after airway stent insertion. Approximately 69% of PTTS patients finally maintained airway patency after the stent was removed. Factors related to successful stent removal at the first attempt were older age and male sex. Absence of parenchymal calcification, segmental consolidation & bronchiolitis, and no trachea involved lesion were relevant to the successful stent removal. Stent dwelling for 12-24 months was associated with successful stent removal compared to a duration of less than 12 months. For patients whose airway patency is determined to be maintained even without a stent, it is necessary to attempt stent removal in consideration of factors related to successful stent removal.

Long-term efficacy and safety of the Dumon stent for treatment of benign airway stenosis.

The long-term efficacy of the Dumon stent in the treatment of benign airway stenosis is unclear. The objective of this study was to evaluate the long-term efficacy and safety of the Dumon stent in patients with benign airway stenosis. We retrospectively reviewed patients with benign airway stenosis who were treated with a Dumon stent at the First Affiliated Hospital of Guangzhou Medical University between March 2014 and October 2021. We included patients with successful removal of silicone stents after implantation. The clinical data and information on bronchoscopic interventional procedures and related complications were collected and analyzed. Ninety-nine patients with benign airway stenosis were included. The stent was placed mainly in the trachea (44.4%) and left main bronchus (43.4%). The main type of stenosis was post-tuberculosis bronchial stenosis (57.6%). The overall cure rate was 60.6%. Stent-related complications included retention of secretions (70.7%), granuloma formation (67.7%), stent angulation (21.2%), and stent migration (12.1%). The stent was less effective for left main bronchus stenosis (p = 0.012). Multivariate logistic regression analysis identified that stent placement for more than 13 months, a stent-intervention number of ⩽ 1 predicted a favorable outcome. The efficacy and safety of the Dumon stent for benign airway stenosis need improvement. The stent is less effective for left main bronchus stenosis; regular follow-up is required in such cases. Stent placement for > 13 months and no more than once stent intervention within a 6-month period were associated with a favorable outcome.

Temporary Stenting for Anastomotic Stenosis after Tracheal Resection of Adenoid Cystic Carcinoma: A Case Report.

A 51-year-old man who noticed discomfort in the pharynx was found to have a tracheal tumor on physical examination. He was diagnosed as having adenoid cystic carcinoma by a transbronchial biopsy and underwent tracheal segmental resection via a collar incision. He was additionally treated with radiation therapy owing to a positive surgical margin, and he subsequently developed anastomotic tracheal stenosis. Silicon stent placement to open the airway was performed for the tracheal stenosis. One year after stent placement, the trachea was dilated, so the stent was removed, and he is still under follow-up without recurrence free 1.5 years after stent replacement.

Dacryocystorhinostomy With and Without Silicone Stent: Is There Any Significant Difference into the Outcomes?

Aim: To compare the difference between the outcomes of endonasal endoscopic dacryocystorhinostomy (En-DCR) with and without silcone tube intubation (stent) for treatment of primary dacryocystitis and phlegmonus dacryocystitis. Method: A hospital based retrospective comparative study of 111 subjects operated for dacryocystitis between October 2014 to May 2021 were analyzed, of which 60 were with silicone stent and 51 were without silicone stent. Silicone tubes were kept in the lacrimal passages for 3 months. In this study we compare the surgery follow up from 3 to 6 months and the complication after each surgery. Surgery was defined as a functional success when there was no evidence of postoperative epiphora, purulent secretions, infection, granuloma, recurrence of dacryocystitis observed upon endonasal endoscopic evaluation. Results: A total of 111 consecutive endoscopic transnasal dacryocystorhinostomy procedures performed at American Hospital 1 of Tirana between October 2014 and May 2021 were reviewed. Of the 111 patients with acute dacryocystitis, 60 (54.05%) were treated with silicone stent (group A) and 51 (45.94%) were treated without silicone stent (group B). 20 of 111 (18%) were diagnosed with phlegmonous dacryocystitis of wich 7 (11.67%) were part of group A and 13 (25.49%) were part of group B. On six months of surgery all the patients were followed up. Only 7 patients (11.66%) in the group A had complications such us purulent secretions (2 or 28.57%), infection (3 or 42.85%), epiphora (1 or 14.28%), granuloma (1 or 14.28%) and none in the group B had any of them. No complications were encountered in patients with phlegmonous dacryocystitis. Conclusion: Dacryocystorhinostomy with silicone tube intubation and without silicon tube intubation are two different procedures without any significant difference in the rate of success. In the light of differences in its complications this study supports the routine without silicone stent of acute dacryocystitis and phlegmonous dacryocystitis patients following En-DCR surgery, suggesting that stents are not necessary for primary DCRs.&#x0D; &#x0D; Received: 26 September 2022 / Accepted: 27 November 2022 / Published: 20 December 2022

Surgical Method for Glottic Web and Vocal Fold Adhesion

Laryngeal web most frequently occurs due to acquired rather than congenital factors. It can cause dysphonia and airway disorder depending on the extent of the area or thickness of the web. The prevention of relapse after web resection is the most important aspect of surgery for laryngeal web. A local mucosal flap can be developed using the superior and inferior surface of the web. This flap can cover at least one side of the wound on the vocal fold after web resection, and consequently leads to primary healing. The other technique for preventing web relapse is to place a stent (also called a “keel”) at the anterior commissure after removing the web. A slim silicone tube can be used as a stent to prevent web relapse. A membrane like plate can also be adopted. The round-shaped silicone tube has an advantage in softness for the vocal fold in comparison to a flat-shaped plate. One of the disadvantages of the silicone tube is that it cannot cover the wound that develops after the resection of a broad web affecting the posterior membranous vocal fold. To resolve this problem, we developed a new type of silicone stent that includes both a tube and a plate component. An appropriate surgical method and stent should be chosen based on the condition of the web.

Value of transvaginal three-dimensional ultrasound in evaluating the curative effect of Yangmo decoction in the treatment of uterine adhesion.

Intrauterine adhesions (IUA) is the damage of the basal layer of the endometrium caused by various reasons, resulting in adhesion of the uterine muscle walls to each other, which is manifested as clinical symptoms such as spanomenorrhea, amenorrhea, and infertility. Hysteroscopic adhesiolysis (HA) is the main treatment, for patients with moderate or severe adhesion or angular adhesion, the incidence of postoperative adhesion is high. Traditional Chinese medicine "Yangmo decoction" can promote endometrial growth. Three-dimensional transvaginal ultrasonography (3D-TVUS) can judge IUA and evaluate uterine receptivity through three-dimensional imaging. This study aims to investigate the value of 3D-TVUS in judging the efficacy of Yangmo decoction in the treatment of intrauterine adhesions. The clinical data of patients who underwent HA at two different centers in department of Gynecology of Third Xiangya Hospital of Central South University and Changsha Jiangwan Hospital from January 2021 to August 2021 were retrospectively collected. A total of 275 eligible patients were included. According to the postoperative management measures, the selected patients were divided into two groups. Yangmo decoction group (n=138): the use of Yangmo decoction and uterine-shaped silicon stent post HA; Hormone group (n=137): the use of estrogen, progesterone and uterine-shaped silicon stent post HA. The preoperative general data, preoperative and postoperative 3D-TVUS parameters of the two groups were analyzed. The endometrial thickness of Yangmo decoction group was thicker than that of hormone group (P<0.001), the intercornual distance was wider (P=0.016), the endometrial echo was more homogeneous (P=0.018), the percentage of bilaterally visible tubal opening was higher (P<0.001), the endometrial morphology was better (P=0.012), and endometrial blood flow, endometrial motility and uterine motion were better in Yangmo decoction group than that in the hormone group (all P<0.001). The endometrial thickness, echo, blood flow, and peristalsis, the number of visible tubal opening, uterine motion, and the intercornual distance obtained by 3D-TVUS examination are important factors to evaluate the prognosis of postoperative drug treatment for IUA. 3D-TVUS is of great significance in evaluating the efficacy of Yangmo decoction in the treatment of IUA.

Bicanalicular-nasal silicone stent for deep canalicular laceration management

We evaluated the efficacy and clinical outcomes of bicanalicular-nasal silicone stents for deep canalicular lacerations and their anatomical restoration advantages. This retrospective case series study included patients with deep canalicular lacerations who underwent bicanalicular-nasal silicone stent intubation between January 2010 and June 2021 at a Chinese tertiary hospital and two primary hospitals. Intra- and post-operative complications were recorded. Anatomical, functional, and cosmetic outcomes were evaluated as anatomical restoration assessments at the last follow-up. We defined anatomical success as a free passage with no reflux during irrigation. Functional success was evaluated using the Munk epiphora scale and fluorescein dye disappearance test. Cosmetic outcomes were evaluated by examining the eyelid, lacrimal punctum, and medial canthus for any structural abnormalities and recorded objectively using a grading scale. We evaluated 92 eyes of 92 patients (63 men and 29 women); the mean distance from the lateral lacerated end to the punctum was 7.74 mm (range 7-10 mm). Bicanalicular-nasal silicone stents were successfully used in all 92 eyes with no severe intra- or post-operative complications noted. The stent placement duration ranged from 12 to 16 weeks (mean, 13.18 weeks). The follow-up period after stent removal ranged from 3 to 12 months (mean, 6.04 months). The anatomical and functional restoration success rates were 96.74% (89/92) and 100% (92/92), respectively. Satisfactory eyelid position realignment was achieved in all patients. Bicanalicular-nasal silicone stent placement sufficiently relieved orbicularis muscle tension during deep canalicular laceration repair, providing good functional results and excellent cosmetic realignment and anatomical restoration of the eyelid.

A Review of Recent Patents on Structures Related to Tracheal Stents

Background: The trachea is an important part of the respiratory system. Long-term airway diseases and the effects of human physiological conditions can cause trachea stenosis. This will seriously affect patients’ physical health. Tracheal stents can provide durable support by means of dilating the narrowed area; they can effectively relieve the patient's breathing difficulties, which is of value that is more practical. Objective: To meet the vital requirements for better adaptation to the human airway environment and prevent complications associated with stent placement, the construction and materials of tracheal stents have been improved constantly. Methods: This paper investigates various representative patents related to the tracheal stent. The structure type, placement method and applications situation of these tracheal stents are discussed. Results: The characteristics of different types of tracheal stents are analyzed. This paper analyzes the main problems in its development. The solutions to the issues and the current and future research on tracheal stents are discussed. Conclusion: The tracheal stents are classified into metal stent, silicone stent, biodegradable stent and hybrid material stent. Further improvements are needed in the aspects of structural design, safety, applicability, biocompatibility, algorithm of drive model of tracheal stent. More related patents about tracheal stents need to be developed.

Canalicular laceration repair with a novel bicanalicular silicone tube.

This study aimed to investigate the efficacy and safety of canalicular laceration repair using a novel bicanalicular silicone tube. Retrospective and consecutive patients who underwent canalicular laceration repair using novel Runshi-RS bicanalicular silicone stents from January 2020 to February 2021 were included. The stent was placed for 3 months, and patients were followed up for more than 3 months after extubation. Demographics, causes of eyelid injuries, placement time and position of stent, and surgical outcomes at follow-up were recorded. Anatomical success was evaluated by diagnostic probing and irrigation of lacrimal passage, while functional success was evaluated by the patient's subjective symptoms of epiphora. This study included 43 patients with canalicular laceration. The median age was 43 years (3-75 years). The average duration of stent implantation was 12.9 weeks, and the follow-up time was 8.8 months. No complications were observed in any patients during operation and follow-up. After extubation, irrigation of the lacrimal passage in 43 eyes showed no obstruction, and the anatomical success rate was 100%. Overall, 39 patients (90.7%) had no subjective symptoms of epiphora. All patients got good cosmetic results. Furthermore, subgroup classification showed deep laceration group (distance from laceration to punctum>5mm) accounted for 51.2%, and the functional success rate of the deep laceration group was lower than that of the shallow laceration group. Runshi-RS bicanalicular silicone stent achieved good anatomical (100%) as well as functional (90.7%) success and good cosmetic results (100%) in patients with canalicular laceration repair.

Comparison of Mirabegron plus Tamsulosin and Tamsulosin Monotherapy for the Treatment of Ureteral Stent-Related Symptoms: A Prospective Randomized Study

Introduction: The aim of this study was to compare the efficacy of mirabegron plus tamsulosin to tamsulosin monotherapy in terms of ureteral stent-related discomfort after ureteroscopic lithotripsy. Methods: A total of 102 patients undergoing ureteroscopic lithotripsy and silicone ureteral stent placement were enrolled in this study. Patients were randomized 1:1 to receive either tamsulosin 0.4 mg once daily or mirabegron 50 mg + tamsulosin 0.4 mg once daily during the stenting period. Before the operation, the IPSS, QOL, and pain score were collected. On the day of ureteral stent removal, the USSQ, analgesic usage amount was collected and recorded. Results: The median USSQ-body pain score in the tamsulosin group and tamsulosin + mirabegron group was 15 and 16, respectively (p = 0.530). The median analgesic usage in the two groups was 3 and 2, respectively (p = 0.170). The median USSQ-urinary symptoms, USSQ-general health, USSQ-work performance, USSQ-sexual matters, and USSQ-additional problems in the two groups were 26 and 26 (p = 0.194), 11 and 12 (p = 0.068), 12 and 13 (p = 0.105), 2 and 2 (p = 0.437), 9 and 9 (p = 0.533), respectively. The international patients used more analgesics than Chinese patients (6 vs. 1, p = 0.015). Conclusion: Compared to tamsulosin alone, tamsulosin + mirabegron showed no additional benefit on the ureteral stent-related pain control after ureteroscopic lithotripsy and silicone stent placement. There was no significant difference on the analgesic usage and USSQ scores between the two groups. Chinese patients request fewer analgesics than international patients.

Intervention to severe lower trachea obstruction supported by extracorporeal membrane oxygenation in a human immunodeficiency virus patient: A case report and literature review

Here we reported a case, male, 33 years old, diagnosed with human immunodeficiency virus (HIV) infection 5 months ago, but he didn’t take antiretroviral drugs regularly. He was admitted to intensive care unit emergently due to hypoxemia, hypercapnia, and hypotension. CT showed severe lower trachea obstruction caused by soft tissue. After rapid bedside assessment, the patient was considered to need endotracheal operation, but he couldn‘t tolerate intubation and mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) was used. Hemodynamics improved significantly along with rehydration and low-dose vasoactive drugs. Subsequently, the patient underwent rigid bronchoscopy, airway tumor resection and Y-type silicone stent implantation. Postoperatively protective endotracheal intubation and mechanical ventilation was followed. ECMO was weaned off after the operation, and endotracheal cannula was removed 6 h later. The pathological examination of excisional tissue showed lung squamous cell carcinoma. Finally, the patient was discharged safely and went to local hospital for further treatment. From this case, we conclude that ECMO could play a key role for those who need endotracheal surgery while cannot endure conventional intubation and mechanical ventilation.

Comparative study of Endonasal Dacryocystorhinostomy with Silicone or polypropylene stents using Mitomycin­C

Comparative study of Endonasal Dacryocystorhinostomy with Silicone or polypropylene stents using Mitomycin­C