Silicone Stents in the Management of Inoperable Tracheobronchial Stenoses – Discussion (1)

Silicone Stents in the Management of Inoperable Tracheobronchial Stenoses - Discussion (1)Obstruction of the stented airway due to local tumor recurrence was observed in 4/5 (80 percent) in group A and in 0/5 in group В (p = 0.02); median survival in group A was 4 months (4 days to 7 months) and in group В it was 6 months (3 to 8 months); this difference did not reach significance. All recurrent obstructions were due to tumor growth either proximal or distal to the indwelling stents, while the stents themselves were never compressed.
The causes of death are listed in Table 4. Apart from one lethal hemoptysis, no death was related to the endobronchial palliation. The one patient who died of asphyxia had his tracheal stent removed after a palliative lobectomy for metastatic osteosarcoma resulted in tracheal decompression, but 2 months later, he died of recurrent tracheal compression through rapid mediastinal tumor spread.
Since the first description of his tracheobronchial stent by Dumon, the use of these silicone endoprostheses has gained increasing popularity. At our institution, we opted for this stent mainly because of patients’ acceptance of a device that was removable. The results in our 31 patients confirmed the ease of insertion and removal of these stents. The fact that they can be fine adjusted with a forceps once they are already deployed presents a clear advantage over other stent types such as the Gianturco stent. We were further able to confirm the excellent tolerance of these “foreign bodies” in the airways.

Table 4—Endoscopic Palliation for Tracheobronchial Stenoses (n — 31): Causes of Death

Cause of Death Patients (n)
Cachexia 10
Heart failure 8
Hemoptysis 4
Pneumonia 4
Pulmonary embolism 2
Asphyxia 1
Intracranial hemorrhage 1
Total 30