Seven-Year Experience with the Dumon Prosthesis

Abstract
The Dumon stent (or Endoxane), designed in 1987, is a flexible, multisized, studded, silicone prosthesis. This report describes the combined results of Dumon stent placement in Marseille, France (J.F.D.), Brescia, Italy (S.C.), Saint-Etienne, France (J.M.V.), and Barcelona, Spain (P.O.). The four teams had placed 1,574 stents in 1,058 patients through September 1994. All cases involved high-grade stenosis of the tracheobronchial tree resulting from extrinsic compression or wall collapse due to loss of cartilaginous support. The locations were the trachea (54%), the left main stem bronchus (21%), the right main stem bronchus (18%), and miscellaneous (8%). The main indications were malignant tumors (677 patients, 926 stents), benign tracheal stenosis (263 patients, 419 stents), postsurgical bronchial stenosis after lung transplantation (15 patients, 36 stents), low-grade malignant tumors (21 patients, 50 stents), and miscellaneous benign stenosis lesions (82 patients, 143 stents). All stents were placed via the rigid bronchoscope. The mean number of stents per patient was 1.5 overall, 1.4 in patients with malignant lesions, and 1.6 in patients with benign tracheal stenosis. The mean duration of stenting was 14 months for benign tracheal disease (longest, 6.2 years) and 4 months for malignancy (longest, 4.7 years). Complications were uncommon, usually easily managed, and rarely life threatening. The main complications were migration (9.5%), obstruction by secretions (3.6%), and granulation (7.9%). Rare complications included airway ulceration, infection, septic shock, and aphonia. Secondary obstruction due to extrinsic compression of the prosthesis was never observed. Routine yearly evaluations are recommended, with other evaluations based on clinical indications. Based on our 7-year experience, we conclude that the Dumon stent represents an effective way to reestablish a viable airway in patients with benign and malignant tracheobronchial disease.