Clinical Analysis Of Ultraflex Stent And Domestic Stent In Patients With Malignant Central Airway Obstruction

Objectives:To explore the clinical efficacy and safety of placement of Ultraflex stent and domestic stent in the treatment of malignant central airway stenosis,and to guide the choice of clinical stent.Method:A retrospective analysis of 132 patients with malignant central airway stenosis admitted to the Department of Respiratory Medicine of Hunan Provincial People’s Hospital from January 2015 to September 2019.Ultraflex stents(n=46)and the imtation Wallstent domestic stents(Micro-Tech,Nanjing,China)(n=86)were placed respectively to collect the clinical features and stent placement of patients in groups A and B,and to follow up the complications and survival after stent implantation.Clinical efficacy and safety of bronchoscopy in the treatment of malignant central airway stenosis by bronchoscopy;according to in vitro and in vivo tests,the changes in the length of the two stents were compared in order to clinically reference is made to the choice of stent size and type for different types of narrow airways.Chi-square tests for Pearson or continuity correction are used to compare categorical variables,and independent or paired sample t-tests are used to compare continuous variables.Result:A total of 161 stents were implanted in 132 patients with malignant airway stenosis,including 49 Ultraflex stents,112domestic stents,155 disposable implants(96.3%),while 2Ultraflex stents and 4 domestic stents failed placing for the first time.There was no significant difference in age,gender and stenosis between the two groups(P>0.05).After stent implantation,the MMRC and ECOG of the two groups were significantly improved compared with preoperative(P<0.05).There was no significant difference in the improvement of MMRC and ECOG score between the two groups(P>0.05).The lung function of A and B groups was significantly improved after implantation(P<0.05).After the stent was placed in the airway,the length of the stent was increased(group AΔLA=1.51±0.935mm,group BΔLB=5.009±1.96 mm,P=0.001).From start to finish,the length changes of the Ultraflex stent and the domestic stent implanted into the airway were statistically significant.The placement of the two stents showed that the Ultraflex stent was more prone to poor inflation(P<0.05)in patients with external compression type(especially in the severe external pressure type of the neck),which compared with the domestic stent.In the late stage of the patients with implanted Ultraflex stents,severe infection was more likely to occur(X2=5.739,P=0.017),while the late stage of the patients implanted domestic stents was more likely to be re-stenosis due to the growth of new organisms into the mesh(X~2=4.822,P=0.028).The average follow-up time was 693 days(31-1421 days),126 deaths(95%),and 2 cases were lost to follow-up.The overall median survival was 2 months,while the median survival of the A and B groups was 3 months and 2 months(P>0.05).The overall 3-month survival rate was 50%,and the 6-months survival rate was 22.5%,while the 3-month survival rate of the A and B groups was 55.8%and 46.9%,and the 6-month survival rate was 30.2%and 18.5%.There were no stent-related serious complications and programmed-related deaths after surgery.Only one patient died of respiratory failure on the second day after stent implantation.The remaining patients died mainly due to disease progression,cachexia and metastasis related.Conclusion:1.Ultraflex stent and domestic stent are safe and effective in the treatment of malignant central airway stenosis,and there is no significant difference between the two stents in instantly improving the patient’s symptoms;2.Ultraflex stents are more prone to serious infections in the long-term,and domestic stents are more prone to restenosis due to the growth of new organisms into the mesh.