AI Article Synopsis
- - The systematic review investigated surgical techniques for managing subglottic stenosis (SGS) in patients with granulomatosis with polyangiitis (GPA), as there are no established guidelines for treatment.
- - Thirteen relevant studies were analyzed, revealing that endoscopic approaches yielded good outcomes, while more invasive methods like open surgery were beneficial when prior treatments failed; tracheostomy was essential for severe cases.
- - A multidisciplinary approach is crucial for effectively managing SGS in GPA patients, taking into account disease activity, stenosis severity, and symptom severity.
Article Abstract
Background: The management of subglottic stenosis (SGS) in granulomatosis patients with polyangiitis (GPA) has no clear guidelines. This systematic review aimed to identify different surgical techniques and evaluate the outcomes of applied procedures.
Methods: An electronic search was performed using 3 major databases, CINAHL, PubMed, and Clinical key, to include relevant studies published from the databases from inception through January 2017. All primary studies reporting treatment of SGS in cases with GPA were included. Articles were excluded if not relevant to the research topic or if they were duplicates, review articles, editorials, short comments, unpublished data, conference abstracts, case reports, animal studies, or non-English studies.
Results: Thirteen papers were included in our systematic review with a total of 267 cases for the qualitative review Endoscopic approaches showed favorable outcomes with the need to use multiple procedures to achieve remission. The open transcervical approach showed excellent results mainly after failure of other endoscopic techniques. Tracheostomy was necessary for severe respiratory obstruction symptoms. Medical treatment was essential for stabilizing the active disease and therefore may enhance the success rate postoperatively.
Conclusion: Subglottic stenosis in patients with GPA requires a multidisciplinary approach to provide optimal management regarding disease activity, grade of stenosis, and severity of symptoms.
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| http://dx.doi.org/10.1177/01455613211036246 | DOI Listing |
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