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Titolo:
SILICONE STENTS IN THE MANAGEMENT OF INOPERABLE TRACHEOBRONCHIAL STENOSES - INDICATIONS AND LIMITATIONS
Autore:
BOLLIGER CT; PROBST R; TSCHOPP K; SOLER M; PERRUCHOUD AP;
Indirizzi:
UNIV HOSP BASEL,DIV RESP CH-4031 BASEL SWITZERLAND UNIV HOSP BASEL,DEPT INTERNAL MED,DIV PNEUMOL CH-4031 BASEL SWITZERLAND UNIV HOSP BASEL,DEPT OTORHINOLARYNGOL CH-4031 BASEL SWITZERLAND
Titolo Testata:
Chest
fascicolo: 6, volume: 104, anno: 1993,
pagine: 1653 - 1659
SICI:
0012-3692(1993)104:6<1653:SSITMO>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
YAG LASER BRONCHOSCOPY; BRONCHIAL OBSTRUCTION; EXPERIENCE; TRACHEAL; IRRADIATION; DILATATION; RADIATION; LESIONS; TUMORS; TREE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
C.T. Bolliger et al., "SILICONE STENTS IN THE MANAGEMENT OF INOPERABLE TRACHEOBRONCHIAL STENOSES - INDICATIONS AND LIMITATIONS", Chest, 104(6), 1993, pp. 1653-1659

Abstract

Background. Various stent models have been developed for the treatment of inoperable stenoses of the central airways caused by external compression. Increasing use is made of the silicone stents designed by Dumon. We tested their technical feasibility, tolerance, and long-term efficacy in relieving respiratory symptoms in patients referred for endoscopic palliation of malignant disease. Methods: All procedures were performed under general anesthesia with the use of the rigid bronchoscope. We inserted 38 stents in 31 patients (median age, 67 years; 25 men and 6 women) whose airways showed residual obstruction of > 50 percent of the lumen after laser resection of endobronchial tumor and/or mechanical dilatation of extrinsic compressions. Results: Stent placement and removal-where necessary-were easy in all patients, but five stents inserted in three patients with short (less-than-or-equal-to 2.5 cm) and conical stenoses migrated, necessitating emergency removal. In 27 of the remaining 28 patients, stent tolerance was excellent; 1 proximal tracheal stent (< 1 cm below the vocal cords) had to be removed because of otalgia and dysphagia. One lethal hemoptysis occurred within hours after a repeated laser therapy and removal of an indwelling stent. No other serious complications occurred. Immediate and lasting relief of dyspnea and improvement in performance status (Karnofsky scale, activity index) was achieved in 90 percent (28/31) of patients (p < 0.01). The influence of adjuvant radiotherapy on local tumor recurrence and survival was analyzed in a subgroup of ten patients with stage IIIB squamous cell carcinoma with comparable performance status. Five didnot undergo adjuvant radiotherapy (group A) and five did (group B). In group A, four of five stents were occluded by tumor recurrence aboveor below the stent after a median follow-up of 2 months; in group B, zero of five were occluded (p < 0.05) after 4 months. Median survival was 4 months in group A and 6 months in group B; the difference did not reach significance. Conclusions: The silicone stents designed by Dumon are easily inserted and removed; they are also well tolerated and very efficacious in relieving respiratory symptoms caused by extrinsic airway compression. Short and conical stenoses present limitations fortheir use due to increased risk of migration. Combined treatment withlaser resection, stent insertion, and subsequent radiotherapy is necessary to prevent local tumor recurrence and may improve survival.

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Documento generato il 04/12/20 alle ore 16:38:42