Fruchter Oren, Abed El Raouf Bayya, Rosengarten Dror, Kramer Mordechai R
*Pulmonary Division, Wolfson Medical Center, Holon †The Sackler School of Medicine, Tel Aviv University, Tel Aviv ‡The Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
J Bronchology Interv Pulmonol. 2017 Jul;24(3):211-215. doi: 10.1097/LBR.0000000000000371.
Whereas stents are considered an excellent treatment for proximal central major airway stenosis, the value of stenting for distal lobar airway stenosis is still controversial. Our aim was to explore the short-term and long-term outcome of metallic stents placed for benign and malignant lobar airway stenosis.
Between July 2007 and July 2014, 14 patients underwent small airway stent insertion. The clinical follow-up included serial semiannual physical examinations, pulmonary function tests, imaging, and bronchoscopy.
The etiologies for airway stenosis were: early post-lung transplantation bronchial stenosis (N=5), sarcoidosis (N=1), amyloidosis (N=1), anthracofibrosis (N=1), right middle lobe syndrome due to external lymph node compression (N=1), lung cancer (N=4), and stenosis of the left upper lobe of unknown etiology (N=1). Stents were placed in the right upper lobe bronchus (N=2), right middle lobe bronchus (N=6), left upper lobe bronchus (N=4), linguar bronchus (N=1), and left lower lobe bronchus (N=1). The median follow-up period ranged from 2 to 72 months (median 18 mo). Immediate relief of symptoms was achieved in the vast majority of patients (13/14, 92%). Out of 10 patients with benign etiology for stenosis, 9 (90%) experienced sustained and progressive improvement in pulmonary function tests and clinical condition.
We describe our positive experience with small stents for lobar airway stenosis; further prospective trials are required to evaluate the value of this novel modality of treatment.
尽管支架被认为是治疗近端中央大气道狭窄的一种优秀方法，但支架治疗远端肺叶气道狭窄的价值仍存在争议。我们的目的是探讨为良性和恶性肺叶气道狭窄置入金属支架的短期和长期疗效。
2007年7月至2014年7月期间，14例患者接受了小气道支架置入术。临床随访包括每半年进行一次的系列体格检查、肺功能测试、影像学检查和支气管镜检查。
气道狭窄的病因包括：肺移植术后早期支气管狭窄（n = 5）、结节病（n = 1）、淀粉样变性（n = 1）、肺炭末沉着纤维化（n = 1）、右中叶综合征（由外部淋巴结压迫引起，n = 1）、肺癌（n = 4）以及病因不明的左上叶狭窄（n = 1）。支架分别置入右上叶支气管（n = 2）、右中叶支气管（n = 6）、左上叶支气管（n = 4）、舌叶支气管（n = 1）和左下叶支气管（n = 1）。中位随访期为2至72个月（中位18个月）。绝大多数患者（13/14，92%）症状立即得到缓解。在10例狭窄病因良性的患者中，9例（90%）肺功能测试和临床状况持续且逐步改善。
我们描述了使用小支架治疗肺叶气道狭窄的积极经验；需要进一步的前瞻性试验来评估这种新型治疗方式的价值。
