Stenting of the main airways in malignant processes became part of every day practice in bronchoscopy. Invasion of the main carina and the trachea in the same time however means difficult situation for stenting even for experienced pulmonologist.
We present our three years experience with a newly developed bifurcated silicone dynamic Y stent. From November 1998 to the end of 2001 we inserted 78 silicone Y stents in 72 patients, 41 man, 31 woman, (mean age 57.3 ±22.1 years). All of them were previously treated with the combination of different bronchoscopic methods in order to maintain airway patency. We used rigid instruments, with direct visual control, and fluoroscopy. The length of the stents used were 5–12 cm. In cases of local recurrence after pneumonectomy we placed “half” Y stents in 17 cases. Mechanical tumor extraction, Nd-YAG laser therapy and high dose rate remote afterloading therapy were the most commonly used methods before stent placement.
We did not observe any serious complication. We had to replace Y stents in six cases, all because of tumor overgrowth. The average survival after stent placement was 13 ± 12,9 months. We found significant improvement of quality of life measured on Karnofsky scale (31 ±14%).CONCLUSIONS: This newly developed Y stent is suitable for palliation of malignant processes invading the trachea and the main carina with the main bronchi. After successful reconstruction of airway patency a dynamic silicone Y stent even in the length of 12 cm can be effective in the maintenance of airway patency, without mucus retention.
Providing the necessary airway patency with a bifurcated stent patients can be suitable for further antitumor therapy. Its good tolerance results a better quality of life.
Z. Papai, None.