Indications and clinical outcomes of fully covered self-expandable metallic tracheobronchial stents in patients with malignant airway diseases

Expert Rev Respir Med. 2020 Nov;14(11):1173-1181. doi: 10.1080/17476348.2020.1796642. Epub 2020 Aug 14.

Abstract

Background: Airway stenting is an efficacious approach in management of malignant airway disease (MAD) with improvement in survival outcome.

Objective: To determine the indications and long-term clinical outcomes of tracheobronchial stenting in patients with MAD.

Methods: A cross-sectional review of 51 patients who underwent airway stenting from June 2011 to June 2019 was done. Paired t-test was used to compare mean difference of clinical characteristics between pre- and post-airway stenting. Kaplan-Meier curves were used to assess overall survival.

Results: A total of 51 patients had stent insertion with mean age 46.63±17.10years including 27(52.9%) females. Mainly 37(72.5%) patients had esophageal and 06(11.8%) had lung cancer. The main indications were bronchial stenosis 18(35.3%), tracheal stenosis 11(21.6%) and Tracheo-esophageal/bronchial fistula 13(25.5%). Obstruction was intrinsic, extrinsic and mixed in 20(39.2%), 13(25.5%) and 5(9.8%) patients, respectively. There was statistically significant mean difference in pre- and post-procedure oxygen saturation (mean (M)=89.8, standard deviation (SD)=6.70 vs M =95.5,SD=2.54.p =0.001) and performance status (M =3.65,SD =0.6 vs M =2.59, SD=0.83.p =0.001). Overall median survival was 16±3.44 weeks, highest amongst patients with intrinsic obstruction (27±6.51 weeks).

Conclusion: Airway stenting is an effective endoscopic procedure to re-establish airway patency in MAD with minimal complications..

Keywords: Airway obstruction; fully covered self-expandable metallic stents; trachea-esophageal/bronchial fistula.

MeSH terms

  • Adult
  • Aged
  • Airway Obstruction / diagnosis
  • Airway Obstruction / etiology
  • Airway Obstruction / therapy
  • Bronchial Diseases / diagnosis
  • Bronchial Diseases / etiology
  • Bronchial Diseases / therapy*
  • Bronchial Fistula / therapy
  • Coated Materials, Biocompatible / therapeutic use
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Cross-Sectional Studies
  • Esophageal Neoplasms / complications
  • Esophageal Neoplasms / therapy
  • Female
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Respiratory Tract Neoplasms / complications
  • Respiratory Tract Neoplasms / diagnosis
  • Respiratory Tract Neoplasms / therapy*
  • Retrospective Studies
  • Self Expandable Metallic Stents* / adverse effects
  • Tracheal Stenosis / diagnosis
  • Tracheal Stenosis / etiology
  • Tracheal Stenosis / therapy*
  • Treatment Outcome

Substances

  • Coated Materials, Biocompatible