title: Our Clinical Experience of Self-Expanding Metal Stent for Malignant Central Airway Obstruction.
abstract: BACKGROUND
  We studied the safety, effectiveness, and limitations of airway stenting using self-expanding metal stent (SEMS) in patients with malignant central airway obstruction (CAO).
  
  
  METHODS
  A retrospective review of records of patients undergoing SEMS placement for malignant CAO during year 2013 - 2014 was done.
  
  
  RESULTS
  Sixteen patients (11 males and five females) underwent SEMS placement for malignant CAO. Median (range) age was 66 (54 - 78) years. No perioperative or immediate postoperative complications were seen except acute myocardial infarction (AMI) in one patient. Three patients were transferred to intensive care unit (ICU) for closer monitoring after the procedure and were discharged the next day. All four patients with lung atelectasis on presentation experienced complete re-expansion of the lung post-stenting. The dyspnea was substantially relieved in 14 (87.5%) patients. Two of the three patients who had been intubated were weaned off from the ventilator following stent insertion. Stent patency was maintained until death in all patients except one. Median survival from the date of diagnosis and the date of stent placement in lung cancer, esophageal cancer, and thyroid cancer were 140 (21 - 564) and 85 (15 - 361), 288 (80 - 419) and 61 (60 - 171), and 129 (71 - 187) and 67 (16 - 118) days, respectively. This survival was similar to reported expected survival associated with the underlying malignancy. During follow-up, granulation tissue (n = 1), mucostasis (n = 1), and tumor ingrowth (n = 2) were the most frequently encountered complications.
  
  
  CONCLUSIONS
  SEMSs are safe and effective in reversing respiratory failure caused by malignant CAO, averting premature death, allowing application of cancer targeted therapy, and restoring impending shortened survival to expected life expectancy associated with the underlying malignancy.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Akash
authors.initials: A
authors.lastname: Verma
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Chee Kiang
authors.initials: CK
authors.lastname: Phua
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Qiu Mei
authors.initials: QM
authors.lastname: Wu
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Wen Yuan
authors.initials: WY
authors.lastname: Sim
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Audrey Wee Chuan
authors.initials: AW
authors.lastname: Rui
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Soon Keng
authors.initials: SK
authors.lastname: Goh
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ho
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Ai Ching
authors.initials: AC
authors.lastname: Kor
authors.affiliation: Department of General Surgery, Changi General Hospital, Singapore 529889, Singapore.
authors.forename: Andrew S Y
authors.initials: AS
authors.lastname: Wong
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Albert Y H
authors.initials: AY
authors.lastname: Lim
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: Dessmon Y H
authors.initials: DY
authors.lastname: Tai
authors.affiliation: Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore.
authors.forename: John
authors.initials: J
authors.lastname: Abisheganaden
keywords: Bronchoscopy; Central airway obstruction; Lung cancer; Stent