Endobronchial stent for malignant airway obstructions.
BACKGROUND
Endobronchial stents are used to treat symptomatic patients with benign or malignant airway obstructions.


OBJECTIVE
To evaluate the safety and outcome of airway stent insertion for the treatment of malignant tracheobronchial narrowing.


METHODS
The files of all patients with malignant disease who underwent airway stent insertion in our outpatient clinic from June 1995 to August 2004 were reviewed for background data, type of disease, symptoms, treatment, complications and outcome.


RESULTS
Airway stents were used in 34 patients, including 2 who required 2 stents at different locations, and one who required 2 adjacent stents (total, 37 stents). Ages ranged from 36 to 85 years (median 68). Primary lung cancer was noted in 35% of the patients and metastatic disease in 65%. Presenting signs and symptoms included dyspnea (82%), cough (11.7%), hemoptysis (9%), pneumonia (5.9%), and atelectasis (3%). The lesions were located in the left mainstem bronchus (31%), trachea (26%), right mainstem bronchus (26%), subglottis (14.3%), and bronchus intermedius (2.9%). Conscious sedation alone was utilized in 73% of the patients, allowing for early discharge. Eighteen patients (50%) received brachytherapy to the area of obstruction. Complications included stent migration (one patient) and severe or minimal bleeding (one patient each). Ninety-four percent of the patients reported significant relief of their dyspnea. Three of the four patients who had been mechanically ventilated before the procedure were weaned after stent insertion. Median survival from the time of stent placement was 6 months (range 0.25-105 months).


CONCLUSIONS
Stent placement can be safely performed in an outpatient setting with conscious sedation. It significantly relieves the patient's symptoms and may prolong survival.
Yerushalmi
Rinat
R
Oncology Institute, Rabin Medical Center (Beilinson Campus), Petah Tiqva, Israel.
Fenig
Eyal
E
Shitrit
David
D
Bendayan
Danielle
D
Sulkes
Aaron
A
Flex
Dov
D
Kramer
Mordechai R
MR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D000556:Ambulatory Surgical Procedures; D001918:Brachytherapy; D001980:Bronchi / Q000601:surgery*; D001984:Bronchial Neoplasms / Q000503:physiopathology / Q000601:surgery; D001999:Bronchoscopy; D002283:Carcinoma, Bronchogenic / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012189:Retrospective Studies; D015607:Stents; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome