title: Temporary tracheobronchial stenting in malignant stenoses.
abstract: Endobronchial stent implantation has been successfully employed in malignant stenoses. The aim of this prospective study was to investigate the temporary use of tracheobronchial stents combined with tumour-specific therapy. All patients received stents for primary palliation of dyspnoea followed by radio- or chemotherapy with the aim of stent removal after reduction of the stenosis. In 22 patients suffering from severe malignant strictures, 34 endobronchial stents (29 Strecker-, 3 Dumon-, 1 Orlowski-, 1 Dynamic-Y-stents) were implanted (in 9 patients, 2 stents were necessary). Patients were treated by irradiation (n = 18) or chemotherapy (n = 4) after stent implantation. Significant improvement of dyspnoea (P < 0.001) and partial oxygen pressure (P < 0.01) was observed. In 11 out of 22 cases (50%), the stents could be removed after successful tumour-specific therapy which led to reduction of stenosis after a mean interval of 31.7 (6-104) days (temporary stenting). During the period of tumour-specific therapy, 9 patients died after a mean interval of 132 (13-347) days (definite stenting). In two cases, stents had to be removed after stent compression, stent dislocation and severe cough. The results suggest that temporary stenting, characterised by subsequent successful tumour-specific therapy, is a new valuable therapeutic strategy. It can "bridge the gap" before tumour-specific therapy can take effect. If tumour-specific therapy is ineffective, definite stenting is the palliative method of choice in severe dyspnoea in bronchial carcinoma.
authors.affiliation: Department of Internal Medicine I, Medical School (Charité), Humboldt University, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Witt
authors.forename: S
authors.initials: S
authors.lastname: Dinges
authors.forename: B
authors.initials: B
authors.lastname: Schmidt
authors.forename: R
authors.initials: R
authors.lastname: Ewert
authors.forename: V
authors.initials: V
authors.lastname: Budach
authors.forename: G
authors.initials: G
authors.lastname: Baumann
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010166:Palliative Care / Q000379:methods*; D010313:Partial Pressure; D011446:Prospective Studies; D015607:Stents
chemical_list: D010100:Oxygen