Document Detail


Management of malignant tracheobronchial stenoses with the use of airway stents.
MedLine Citation:
PMID:  15617306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tracheobronchial stenoses caused by malignant etiologies are life-threatening with respiratory distress symptoms. Airway stent insertion is an effective method of relieving the airway obstruction. We report our experience with the use of Dumon silicone stents and self-expandable metallic Ultraflex stents. METHODS: From July 1999 to December 2003, ten patients (7 men, 3 women) with a mean age of 56.3 years (range, 37 to 77 years) had stent insertion to manage their malignant airway stenoses. Underlying malignancies included 6 esophageal cancers, one NPC with mediastinal recurrence, 1 recurrent adenoid cystic carcinoma, 1 metastatic mediastinal lymphadenopathy and 1 mediastinal multiple myeloma. All patients had severe respiratory distress. All stents were placed through a rigid Efer-Dumon bronchoscope under general anesthesia. RESULTS: Eight Dumon silicone stents (4 tracheal, 1 bronchial and 3 Y-shaped) were placed in 7 patients. Four metallic Ultraflex stents (2 tracheal and 2 bronchial) were placed in 3 patients. There was no death related to stent placement, and there were no immediate complications after stenting. Significant improvement of respiratory distress was seen in 9 patients (90%) after stenting. Three stent migrations occurred in 12 stent placements. During follow-up to the present time, 7 patients died of disease progression, with a median survival of 5.2 months (range, 1 to 17.8 months) after stenting. Two patients remain alive, with survivals of 49 and 12 months respectively. CONCLUSIONS: The insertion of the airway stents, either Dumon silicone stents or metallic Ultraflex stents, can provide an effective method to immediately relieve respiratory distress, to improve the quality of life and to prolong survival in patients with malignant central airway stenoses.
Authors:
Jang-Ming Su; Tzu-Chin Wu; Ming-Fang Wu; Han Chang; Ming-Chih Chou
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the Chinese Medical Association : JCMA     Volume:  67     ISSN:  1726-4901     ISO Abbreviation:  J Chin Med Assoc     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-12-24     Completed Date:  2005-01-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101174817     Medline TA:  J Chin Med Assoc     Country:  China (Republic: 1949- )    
Other Details:
Languages:  eng     Pagination:  458-64     Citation Subset:  IM    
Affiliation:
Division of Thoracic Surgery, Department of Surgery, Chung-Shan Medical University Hospital, Taichung, Taiwan, ROC.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bronchial Diseases / mortality,  therapy*
Esophageal Neoplasms / complications*,  mortality,  therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Stents*
Tracheal Stenosis / mortality,  therapy*

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