Chest
A Dedicated Tracheobronchial Stent
Section snippets
METHODS AND MATERIALS
Between March 1987 and March 1989, 66 patients (45 men and 21 women) were intubated. The ages of these patients varied from 8 to 83 years (mean age: 54 years). Of these 66 patients, 21 had squamous cell carcinoma; two, oat cell carcinoma; seven, adenocarcinoma; three, adenoid cystic carcinoma; one, carcinoid tumor; one, Hodgkin's tumor; one, lymphoma; one, leiomyosarcoma; and one, mediastinal tumor. The remaining cases included two of amyloidosis, 23 of tracheal stenosis, and three of bronchial
CASE 1
In June 1987, a 19-year-old woman underwent emergency laser resection for an adenoid cystic carcinoma involving the lower third of the trachea and both main stem bronchi. In the following two months, she required four more laser treatments because of repeated restenosis of the left bronchi causing acute respiratory insufficiency. Under these conditions radiotherapy could not be undertaken. On September 10, 1987, we decided to insert a stent in the left main stem bronchus. With the stent in
RESULTS
Intubation was successful in all cases in this series. A total of 118 prostheses were inserted in the 66 patients, more than one prosthesis having been used in some patients either successively (17 cases: two to seven prostheses) or simultaneously (11 cases: two to three prostheses). The prosthesis was placed in the trachea in 59 cases, in the left main stem bronchus in 34, in the right main stem bronchus in 16, in the right lower lobe bronchus in five, in the left lower lobe bronchus in one
DISCUSSION
The foremost cause of death in lung cancer patients who have exhausted all therapeutic options is, of course, suffocation. It is thus quite certain that the lives of these patients could be extended significantly if patency could be maintained. Endoluminal obstruction can be removed using the YAG laser through an endoscope, but if extrinsic compression is involved, YAG resection, when feasible, only achieves temporary relief at best.
Theoretically a stent is a straightforward way to maintain an
ACKNOWLEDGMENTS
I am grateful to Andy Corsini for his help in preparing this manuscript.
REFERENCES (5)
Palliative intubation of the trachea and main bronchi
J Thorac Cardiovasc Surg
(1980)Palliative intubation of the tracheobronchial tree
J Thorac Cardiovasc Surg
(1987)
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Manuscript received April 18; revision accepted June 23.