An outcome analysis of self-expandable metallic stents in central airway obstruction: a cohort study
Open Access
- 8 April 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Cardiothoracic Surgery
- Vol. 6 (1), 1-8
- https://doi.org/10.1186/1749-8090-6-46
Abstract
Background: Self-expandable metallic stents (SEMSs) have provided satisfactory management of central airway obstruction. However, the long-term benefits and complications of this management modality in patients with benign and malignant obstructing lesions after SEMS placement are unclear. We performed this cohort study to analyze the outcomes of Ultraflex SEMSs in patients with tracheobronchial diseases. Methods: Of 149 patients, 72 with benign and 77 with malignant tracheobronchial disease received 211 SEMSs (benign, 116; malignant, 95) and were retrospectively reviewed in a tertiary hospital. Results: The baseline characteristics of patients who received SEMS implantation for benign conditions and those who underwent implantation for malignant conditions were significantly different. These characteristics included age (mean, 63.9 vs. 58; p < 0.01), gender (male, 62% vs. 90%; p < 0.0001), smoking (47% vs. 85%; p < 0.0001), forced expiratory volume in 1 second (mean, 0.9 vs. 1.47 L/s; p < 0.0001), follow-up days after SEMS implantation (median; 429 vs. 57; p < 0.0001), and use of covered SEMS (36.2% vs. 94.7%; p < 0.0001). Symptoms improved more after SEMS implantation in patients with benign conditions than in those with malignant conditions (76.7% vs. 51.6%; p < 0.0001). The overall complication rate after SEMS implantation in patients with benign conditions was higher than that in patients with malignancy (42.2% vs. 21.1%; p = 0.001). Successful management of SEMS migration, granulation tissue formation, and SEMS fracture occurred in 100%, 81.25%, and 85% of patients, respectively. Conclusions: Patients who received SEMS implantation owing to benign conditions had worse lung function and were older than those who received SEMS for malignancies. There was higher complication rate in patients with benign conditions after a longer follow-up period owing to the nature of the underlying diseases.Keywords
This publication has 22 references indexed in Scilit:
- Stenting allows weaning and extubation in ventilator- or tracheostomy dependency secondary to benign airway diseaseRespiratory Medicine, 2007
- Self-Expandable Metallic Airway Stents and Flexible Bronchoscopy *Social psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2003
- Experience with ultraflex expandable metallic stents in the management of endobronchial pathologyThe Annals of Thoracic Surgery, 2002
- ERS/ATS statement on interventional pulmonologyEuropean Respiratory Journal, 2002
- Interventional PulmonologyThe New England Journal of Medicine, 2001
- Flexible bronchoscopy: a safe method for metal stent implantation in bronchial diseaseThe Annals of Thoracic Surgery, 2000
- Multidisciplinary approach to management of postintubation tracheal stenosesEuropean Respiratory Journal, 1999
- The Use of Expandable Metal Stents to Facilitate Extubation in Patients With Large Airway ObstructionSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1998
- Therapeutic Rigid Bronchoscopy Allows Level of Care Changes in Patients With Acute Respiratory Failure From Central Airways ObstructionSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1997
- Kyphoscoliosis and Bronchial TorsionSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1997