Study on the treatment of tracheobronchial stenosis using expandable metallic stents.

Abstract

The purpose of this study is to clarify the clinical usefulness of Gianturco-Z stent (G-Z stent) for the management of malignant and benign tracheobronchial stenosis. Seventy-three stents were used in 30 patients. In 20 cases, we used the so-called "stent-in-stent" method. Twenty-four patients were grade 5, and 6 were grade 4 according to the Hugh-Jones classification of respiratory status. The technical success rates, clinical condition, respiratory status, blood gas analysis, survival rate, and complications were reviewed on the basis of the patients'medical records and radiographs. All stents were successfully placed in the appropriate position. After the procedure, respiratory status improved in 97% (29/30) of the patients. PaO(2) increased statistically (p<0.05), and PaCO(2) decreased one week after the treatment. Mean survival of 30 patients after stent placement was 123 days. Mean survival in 9 malignant patients treated in combination with radiotherapy (182 days) was statistically longer (p<0.01) than in those treated without radiotherapy (65 days, n=20). The tracheobronchial burn patient who received a combination of stent placement and post operative radiotherapy survived 540 days. No major complications were encountered during or after the procedure. Only 3 minor complications were observed: 1 stent migration, 1 partial rupture of the stent, and 1 stent deformation. G-Z stent treatment with the "stent-in-stent" technique is useful for palliation of malignant and benign tracheobronchial stenosis, and should contribute to improving the quality of life in patients with advanced cancer.