Tjahjono Richard, Chin Ronald Yoon-Kong, Flynn Peter
Department of Otolaryngology Head and Neck surgery, Nepean Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
BMJ Support Palliat Care. 2018 Sep;8(3):335-339. doi: 10.1136/bmjspcare-2018-001522. Epub 2018 Jun 18.
To evaluate the outcomes of tracheobronchial stenting in patients with malignant central airway obstruction and assist practitioners in palliative settings in understanding the indications, contraindications and management of tracheobronchial stents.
This retrospective study involved a consecutive case series of palliative patients with central airway obstruction secondary to inoperable cancers who underwent tracheobronchial stenting at a single institution. The European Cooperative Oncology Group (ECOG) scale was used to evaluate patient functional status before and after tracheobronchial stenting.
Twenty-three patients underwent tracheobronchial stenting for malignant central airway obstruction. The majority of patients presented with symptoms of worsening dyspnoea (21 of 23; 91%). Postoperatively, there was a significant improvement in mean ECOG performance status from 2.88±0.34 to 1.58±0.50 (p<0.01). There was no intraoperative mortality resulting from tracheobronchial stenting. Five patients (21.74%) re-presented to hospital due to worsening symptoms and required emergency bronchoscopy. Two patients had stent migration, requiring stent replacement. One patient restenosed from tumour granulation, requiring microdebrider to debulk the mass. Two patients had stent failure secondary to external tumour compression, leading to death.
Tracheobronchial stenting is a safe and effective procedure that offers rapid palliation of symptoms and improvement in patient functional status.
评估气管支气管支架置入术治疗恶性中央气道梗阻患者的疗效，并帮助姑息治疗环境中的从业者了解气管支气管支架的适应证、禁忌证及管理方法。
本回顾性研究纳入了一系列连续的姑息治疗患者，这些患者因无法手术切除的癌症导致中央气道梗阻，在单一机构接受了气管支气管支架置入术。采用欧洲癌症研究与治疗组织（ECOG）量表评估气管支气管支架置入术前和术后患者的功能状态。
23例患者接受了气管支气管支架置入术以治疗恶性中央气道梗阻。大多数患者出现呼吸困难加重症状（23例中的21例；91%）。术后，ECOG表现状态平均从2.88±0.34显著改善至1.58±0.50（p<0.01）。气管支气管支架置入术未导致术中死亡。5例患者（21.74%）因症状加重再次入院，需要紧急支气管镜检查。2例患者出现支架移位，需要更换支架。1例患者因肿瘤肉芽组织导致支架再狭窄，需要使用微型清创器清除肿块。2例患者因外部肿瘤压迫导致支架功能障碍，最终死亡。
气管支气管支架置入术是一种安全有效的手术，可迅速缓解症状并改善患者功能状态。
