Oct 1, 1996

Emergency stenting of malignant obstruction of the upper airways: long-term follow-up with two types of silicone prostheses

The Journal of Thoracic and Cardiovascular Surgery
K WassermannR P Müller


We evaluated the long-term prognosis of stents placed on an emergency basis in the trachea and its bifurcation for malignant stenosis. We retrospectively analyzed all bronchologic treatments of obstructing airway lesions from January 1993 to December 1995. We report on 10 patients with severe malignant "mixed-type" obstruction of the proximal trachea or distal trachea plus both main-stem bronchi. They had far-advanced inoperable tumor (esophageal cancer: n = 4; lung cancer: n = 3; recurrent laryngeal, uvula, and thyroid cancer: n = 1 each). Emergency treatment consisted of a dilating bougie maneuver followed by the insertion of a large one-way (n = 4) or Y-shaped silicone prosthesis (n = 6). After the intervention, there was a long-lasting clinical improvement. Median survival from stent insertion was 8 months for all patients irrespective of tumor type; it was 5 months for patients with lung carcinoma and 8 months for those with esophageal cancer. The results are in accordance with other studies using different therapeutic modalities. Stent exchange was necessary in five patients. Main reasons were continuing tumor growth beyond the proximal and distal boundaries and recurrent productive bronchial infection. Patients died of p...Continue Reading

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Mentioned in this Paper

Endoscopy (Procedure)
Hemispheral Lobule IX
Respiratory Tract Neoplasms
Stent, Device
Anatomic Bifurcation
Tracheal Stenosis
Blastocyst Implantation, Natural

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