Fenestrated versus conventional Dumon stent in the management of benign central airway stenosis

<bold>Background:</bold> Dumon stents are an important treatment option for benign central airway, with advantage of tissue compatibility, easy removal and replacement, and modifiability. However, they have several major drawbacks, including migration, granulation formation, and mucus retention. We aim to fenestrate on the Dumon stent to reduce the incidence rate of complications and compare the efficacy after deployment and complications with conventional Dumon stent. <bold>Methods:</bold> We retrospectively included patients with benign central airway stenosis treated with Dumon stents between 2019 and 2023. Complications were assessed under bronchoscopy. Cox proportional hazard regression model was used for competing risks. Cumulative recurrence curves were analyzed by the Kaplan-Meier method. <bold>Results:</bold> 118 patients (53 with fenestrated Dumon stents and 65 with conventional Dumon stents) were included. Stent was successful placed in all cases with symptoms relieved. Granulation formation was the most frequent complication (24.5% with fenestrated and 49.2% with conventional stent; p=0.006), followed by mucus retention (28.3% with fenestrated and 40% with conventional stent; p=0.184) and migration (5.6% with fenestrated and 23.1% with conventional stent; p=0.009). Fenestrated stent has lower risk of granulation (HR= 0.3296, p= 0.0043) and migration (HR= 0.2215, p= 0.017). The cumulative incidence of granulation (p=0.0031) and migration (p=0.0089) in fenestrated group was significantly higher than conventional group. <bold>Conclusions:</bold> The fenestrated Dumon stent has comparable efficacy with conventional Dumon stent, with a lower incidence of migration and granulation in the management of benign central airway stenosis.