Dalar Levent, Abul Yasin
Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey.
Stony Brook University School of Medicine, Stony Brook, NY.
J Bronchology Interv Pulmonol. 2018 Jul;25(3):212-217. doi: 10.1097/LBR.0000000000000486.
Silicone stenting has been used to palliatively manage respiratory symptoms in patients with airway stenoses. Oki and Saka recently developed stents that can be used to manage stenoses around the carina between the bronchus to the right upper lobe and the bronchus intermedius (termed the primary right carina). The aim of this study was to assess the efficacy and safety of Oki stenting used to treat airway stenosis around the primary right carina.
We included 5 patients with airway stenoses. All Oki stenting procedures were performed with the patients under general anesthesia using either rigid or flexible bronchoscopy.
Oki stents were successfully placed in all 5 patients, and the dyspnea index improved in all. Modified Oki stenting was performed at the anastomotic site of 1 patient who had undergone sleeve resection. Four patients had airway obstructions caused by malignant disease. No serious procedural or early complication was noted. One patient died of liver insufficiency, and another with a malignancy died from cranial metastasis of the primary tumor.
Oki stenting of the primary right carina is safe, efficient, and acceptable when used for palliative management of airway obstruction, even after sleeve resection; in the latter case, some procedural modifications are required.
硅胶支架已被用于缓解气道狭窄患者的呼吸道症状。冲木和坂最近开发了可用于处理右上叶支气管与中间支气管之间（称为右主隆突）隆突周围狭窄的支架。本研究的目的是评估冲木支架治疗右主隆突周围气道狭窄的有效性和安全性。
我们纳入了5例气道狭窄患者。所有冲木支架置入手术均在全身麻醉下使用硬式或软式支气管镜对患者进行。
5例患者均成功置入冲木支架，且所有患者的呼吸困难指数均有所改善。1例接受袖状切除术的患者在吻合部位进行了改良冲木支架置入。4例患者的气道阻塞由恶性疾病引起。未观察到严重的手术相关或早期并发症。1例患者死于肝功能不全，另1例恶性肿瘤患者死于原发肿瘤的脑转移。
右主隆突的冲木支架置入术在用于气道阻塞的姑息治疗时是安全、有效的且可接受的，即使在袖状切除术后也是如此；在后一种情况下，需要进行一些手术改良。
