Treatment Of Malignant Airway Stenosis With Stents Covered Iodinne Radioactive Seeds

Objective To evaluate the efficacy and safety of stent loaded with iodine125 seeds in the treatment of malignant airway stenosis.Methods Eight patients with malignant airway stenosis diagnosed in the second affiliated Hospital of Guangxi Medical University and were unable to undergo surgery or recrudescence after surgery through multi-disciplinary consultation,who were treated with intravenous combined sedation combined with local anesthesia.The prepositioned position of the airway stent was determined by bronchofiberoscope.After inserting the distal end of the external sheath tube of the insertion device from the distal end of the trachea to the distal end of the stenosis segment of the trachea,the stent was inserted into the internal cavity of the external sheath of the insertion device to release the stent.Under the guidance of fiberoptic bronchoscopy,tracheal intubation was inserted into the distal end of the stenosis segment of the trachea,and tracheal intubation was used instead of the external sheath tube to establish the channel.After loading the particles,the stent is loaded into the outer tube of the device,and the outer tube is inserted into the outer tube of the device through the tube insertion tube,the stent in the outer tube of the introducer is pushed by the original stent pusher,and the stent is released in the proposed position.ECOG score,blood routine,blood gas analysis,chest CT,fiberoptic bronchoscopy were performed in 8patients before and after operation,which were used to evaluate the improvement of airway stenosis and the inhibition of iodine 125 seeds on hematopoiesis.Results The iodine 125 radioactive particle stent was successfully placed in 8 patients with correct position and good stent expansion.After the stent was placed,the symptoms of dyspnea,the blood gas analysis of the patient were immediately relieved,and the results of the CT and the fiberoptic bronchoscope were improved.The activity endurance of the patients was enhanced and the ECOG score was reduced after the post-operation follow-up.One patient experienced mild airway restenosis,and it can be improved after cleaning up the necrotic tissue under bronchoscope;one patient died after 1 month of stent implantation;in one case the tumor was reduced after radiotherapy,the diameter of the narrow section was increased,and the stent was cough out after the stent was placed in the stent for 4 months.No bone marrow suppression,iodine 125 particle shedding,radiation pneumonitis,radiation esophagitis,large bleeding and tracheo-esophageal fistula were not happened.Conclusions Stents loaded with iodine 125 radioactive particles can rapidly alleviate malignant airway stenosis,significantly reduce restenosis and prolong survival time.The innovative stent placement method,which was used tracheal intubation No.9 or No.10 as the guide tube to place the stent in the airway,and can place stents that carry more iodine 125 radioactive particles.The therapeutic effect is remarkable.