| PurposeTo evaluate the clinical efficacy and complications of Nitinol stents in the treatment of trachea or bronchi stricture and to retrospectively determine long-term outcomes in patients who have undergone tracheobronchial stent placement.Materials and MethodsUnder X-Ray guided, 45 patients (25 male, 20 female; age ranged from 20 to 87 years, mean 58.2 years) were treated with metallic airway stents for benign or malignant stenosis. 5 patients were due to benign stenosis (including 3 cases of tracheal tube injury, 1 case of oesophageal leiomyoma, 1 case of endo-bronchial tuberculosis), and the other 40 patients were malignant stenosis(19 cases of oesophageal carcinoma, 8 cases of lung cancer, 5 cases of tracheal carcinoma, 3 cases of thyreoid carcinoma, 3 cases of mediastinum carcinoma, 1 case of lung metastatic tumor and 1 case of malignant lymphoma). Presenting symptoms were dyspnea in 35 patients, dysphagia in 8 patients, and failed extubation in two patients. All patients came with their X-Ray, CT or bronchoscope films. The Nitinol stent were used which was 12～20mm in diameter and 30～60mm in length. Followed-up, which ranged from 5～1225 days, was performed by means of clinical visit and telephone interview. Survival was estimated by using the Kaplan-Meier product limits method, SPSS 13.0.Result50 stents were placed in 45 patients, all of which were succeed in technique. It was satisfactory of immediate location in 49 stents(98%). The dyspnea had been conspicuously improved in 36 patients (97.3%). In our study, the patients' mean survival time is 405 days, the median survival time is 232 days. After insertion of stents in 38 cases, among which the diameter of the tracheal stenosis expanded from 6.90±3.46mm to 12.62±2.97mm on average in 23 cases (P＜0.05) , as well as the area increased from 108.27±96.99mm~2 to 177.76±76.8mm~2 (P＜0.05); more over, the diameters remain 11.60±3.51mm with the area of about 153.27±79.03mm~2 for more than 6 months after operation in 14 cases. We found that there was no significant change in diameter and area between the period within 6 months and after 6 months after operation. After insertion of nitinol stents in 8 cases with progressive dysphasia, there was no great significant change in diameter and area before and after operation. Additionally, After in insertion of nitinol stents in cases with different degrees of tracheal stenosis, no significance was found in both diameter and area.Conclusion1. Metallic airway stent placement was a safe, simple and relatively cheap and dependable management with microtrauma for those who had lost the chance of surgical resection or refused to undergo operation presenting dyspnea due to severe tracheobronchial stenosis.2. Metallic airway stent placement can conspicuously improve the dyspnea caused by benign or malignant tracheobronchial stenosis.3. For malignant lesions, placement of stent was only a palliative measure because the stent had no use in treating tumor. When permitted, these patients should undergo one or more other treatment such as chemotherapy and radiation etc.4. During and after the placement of stent, there existed some unavoidable complications such as chest pain, intractable cough, stent migration and restenosis etc. |
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