Study of Various Aiway Stents (Symposium 2)

Background. At the moment, several models of stent exist that are used in the patients with benign and malignant airway stenosis, in order to improve symptoms and to maintain a satisfactory patent airway. Purpose. We reviewed our cases of stent and other reports of airway stent therapy, and discussed which type of stent should be inserted in the different types of airway stenosis. Methods. We inserted various types of airways stents to 50 patients who had inoperable central stenosis with important symptoms of respiratory difficulty. With respect to the cause of the stenosis, 2 patients were by benign disease, while the rest was by malignant disease. Thirty-three patients were placed with metal stents (modified Gianturco Z stent: 19; Spiral Z stent: 14; and Ultraflex stent: 4) and the rest of the 17 patients were placed with silicone stents (Dumon stent: 15; Dynamic stent: 1; and Montgomery silicone T tube: 1). Results. All the patients had an immediate relief of dyspnea after the stent placement. Complications after the metal stent placement were migration, mild hemorrhage and granulation tissue formation, with a complication rate of 16%. With silicone stent, the rate of complications was 59%, with mucus retention, displacement, granulation tissue formation, hemorrhage, laryngeal edema and laryngeal pain. However silicon stent's complications were not so serious in comparison with the complications of metal stent. About the patient's prognosis, both patients with benign stenoses survived to over of 10 years after the stent insertion. The average survival time of the patients with malignant stenoses were about 198 days, although 6 patients managed to survive over one year. Of this 6 patients, 4 had the diagnostic of lung cancer, and were treated with combined radiotherapy and chemotherapy after the stent's placement. A lethal hemoptysis occurred in 5 patients between 2 and 10 months after stenting. These five patients were treated with metallic stent placement and radiotherapy. Conclusion. All the types of stents that we used were well tolerated and showed to be very effective in the treatment of the airway stenosis our long-term observation. In our study the stent of Dumon was safer than metal stent, also can be removed and repositioned. For that reason we considered that Dumon's stent is the first choice of treatment as much in both benign and malignant airway stenosis rather than metal stent.