Chest
BronchoscopyUse of the Dumon Y-stent in the Management of Malignant Disease Involving the Carina: A Retrospective Review of 86 Patients
Section snippets
Materials and Methods
All patients undergoing the placement of a Dumon Y-stent at our interventional endoscopy unit were included in this retrospective study. All stents were placed in patients between July 1, 1994, and April 30, 2002, for malignant disease involving the main carina or because of a tracheoesophageal fistula. The aim of this study was to assess the palliative efficacy and safety of the Dumon Y-stent.
The patients presented to our service with respiratory symptoms of dyspnea, cough, and/or hemoptysis.
Results
Eighty-six patients (75 men and 11 women) with a median age of 60.4 years were included in this retrospective study (Table 2). Sixty percent of patients had primary tracheobronchial malignancies. Thirty-six percent had esophageal cancer, and 3.5% had metastatic disease (Table 3). Non-small cell lung cancer was the most frequently occurring tumor, accounting for 46.6% of cases (Table 3).
The most common indication for Y-stent placement (Table 4) was isolated tracheobronchial obstruction in 53.4%
Discussion
The optimal endoscopic management of tumors involving the main carina should be minimally invasive and should allow for the long-term control of potentially life-threatening tracheobronchial obstructions. It should also be applicable to a majority of patients, among them those deemed inoperable.9 Patient age and prognosis should not be considered absolute contraindications to what is essentially palliative minimally invasive care. In selected patients with tracheobronchial obstructions and
Conclusion
In advanced malignant airway disease, survival is poor, and quality of life is limited by recurrent dyspnea, cough, and hemoptysis. In our experience, the Dumon silicone Y-stent provides a minimally invasive, safe, and effective palliative treatment for patients with malignant obstruction of the central airways. The advantages of the Dumon Y-stent include ease of placement and removal. Based on our experience, we suggest an algorithmic approach to the placement of the silicone Y-stent for
References (20)
- et al.
The changing epidemiology of lung cancer in Europe
Lung Cancer
(2003) - et al.
Therapeutic rigid bronchoscopy allows levels of care changes in patients with acute respiratory failure from central airways obstruction
Chest
(1997) - et al.
Endoscopic treatment of malignant airway obstructions in 2,008 patients
Chest
(1996) - et al.
Resection for bronchogenic carcinoma involving the carina: long-term results and effect of nodal status on outcome
J Thorac Cardiovasc Surg
(2001) - et al.
Stenting for airway obstruction in the carinal region
Ann Thorac Surg
(1998) - et al.
Role of covered esophageal stents in malignant esophagorespiratory fistula
Ann Thorac Surg
(1995) - et al.
Tracheoesophageal fistulas secondary to carcinoma of the esophagus
J Thorac Cardiovasc Surg
(1981) - et al.
Double stenting for esophageal and tracheobronchial stenoses
Ann Thorac Surg
(2000) - et al.
Esophageal carcinoma with airway invasion: evolution and choices of therapy
Chest
(1994) - et al.
Lung cancer: palliative care
Chest
(2003)
Cited by (117)
Airway stenting: State of the art
2022, Revue des Maladies RespiratoiresY-shaped airway self-expanding covered metallic stent removal via the interventional technique
2021, Clinical RadiologyCitation Excerpt :Since the introduction of Y-shaped self-expanding metal stents in 2005,1 airway stents have been more widely used in clinic.2,3 Y-shaped airway self-expanding covered metal stent placement may be a suitable choice in patients with airway stenosis, fistula, or other lesions involving or adjacent to the carina.4,5 This method immediately frees any airway obstruction and relieves symptoms, and also reduces the incidence of stent migration.
Self-expanding metallic Y-stent compared to silicone Y-stent for malignant lesions of the main carina: A single center retrospective study
2020, Respiratory Medicine and ResearchDetermination of patient-specific airway stent fit using novel 3D reconstruction measurement techniques: a 4-year follow-up of a patient
2023, Therapeutic Advances in Respiratory DiseaseAirway stenting for central airway obstruction: a review
2023, Mediastinum
This research was supported by Novatech.