Subscribe to RSS
DOI: 10.1055/s-2003-42615
Y-Nitinol Airway Stent for Management of Central Airway Compression Due to Metastatic Colon Cancer
Publication History
Submitted 12 September 2002
Accepted after Revision 26 May 2003
Publication Date:
10 October 2003 (online)
Introduction
Tumors in the mediastinum, in the area between the esophagus and the tracheobronchial tree, can cause several complications, but mainly may lead to strictures in one or both organs [1]. This results in dysphagia and dyspnea, the latter due to airway compression. Further reasons for the same problems can be post-radiation strictures of both organs which sometimes have to be distinguished from the original tumor stenosis. However, another important cause of airway compression is the insertion of metal stents or plastic tubes in patients with stenosing proximal esophageal cancers [2]. So far, this complication has been mostly treated by implantation of a bifurcating dynamic Y-stent or a Dumon silicone stent, procedures which have to be performed with the patient under general anesthesia [3] [4] [5].
In this report, an innovative fiberbronchoscopic technique is described which enables intracorporeal construction of a prosthetic ”Y” device comprising two self-expanding tracheal nitinol stents, and which can be carried out with the patient under conscious sedation.
References
- 1 Yangihara K, Mizuno H, Wada H, Hitomi S. Tracheal stenosis treated with self-expanding nitinol stent. Ann Thorac Surg. 1997; 63 1786-1790
- 2 Colt H G, Meric B, Dumon J F. Double stenting for carcinoma of the esophagus invading the tracheobronchial tree. Gastrointest Endosc. 1992; 38 485-489
- 3 Freitag L, Tekolf E, Stamatis G, Greschuchna D. Clinical evaluation of a new bifurcated dynamic airway stent. A 5-year experience with 135 patients. Thorac Cardiovasc Surg. 1997; 45 6-12
- 4 Shiraishi T, Kawahara K, Shirakusa T. et al . Stenting for airway obstruction in the carinal region. Ann Thorac Surg. 1998; 66 1925-1929
- 5 Dumon J F. A dedicated tracheobronchial stent. Chest. 1990; 97 328-332
- 6 Hauck R W, Lembeck R M, Emslander H P, Schömig A. Implantation of Accuflex and Strecker stents in malignant bronchial stenoses by flexible bronchoscopy. Chest. 1997; 112 134-144
- 7 Hauck R W, Römer W, Schulz C. et al . Ventilation perfusion scintigraphy and lung function testing to assess metal stent efficacy. J Nucl Med. 1997; 38 1584-1589
- 8 Freitag L, Tekolf E, Steveling H. et al . Management of malignant esophagotracheal fistulas with airway stenting and double stenting. Chest. 1996; 110 1155-1160
- 9 Rösch T, Kyrein A, Zillinger C. et al . Metal stents in gastroenterology. Chirurg. 1999; 70 868-875
- 10 Albes J M, Schäfers H J, Gebel M, Ross U H. Tracheal stenting for malignant tracheoesophageal fistula. Ann Thorac Surg. 1994; 57 1263-1266
R. W. Hauck, M.D.
Department of Internal Medicine II, Krankenhaus Bad Reichenhall
Riedelstr. 5 · 83435 Bad Reichenhall · Germany
Fax: + 49-8651-772682
Email: hauck@krankenhaus-bad-reichenhall.de