Bi Yonghua, Ren Jianzhuang, Chen Hongmei, Bai Liangliang, Han Xinwei, Wu Gang
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University.
Department of Ultrasound, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
Medicine (Baltimore). 2019 Jan;98(3):e14169. doi: 10.1097/MD.0000000000014169.
We aimed to evaluate the safety and efficacy of combined airway and esophageal stents under fluoroscopy guidance and local anesthesia for patients with malignant tracheobronchial and esophageal disease. This retrospective analysis included 35 consecutive patients underwent combined stenting from March 2012 to August 2016. All patients underwent chest computed tomography scans before stenting and during follow-up. Thirty-nine airway stents and 43 esophageal covered stents were implanted. The indication of stenting, technical success and postinterventional complications were collected and analyzed. Thirty-nine airway stents and 43 esophageal covered stents were implanted. Stenting failed in 1 airway stent, and 2 esophageal stents, with technology success rates of 97.4% and 95.3%, respectively. No procedure-related death occurred, only 1 patient died from failure of respiration due to esophagotracheal fistula. The median interval between 2 stenting was 13.0 days. Both dyspnea and dysphasia were significantly relieved after stenting. Restenosis after stenting (7.7%) was the most common complication for airway stenting, all these cases required second stenting. Stent migration (7.0%) was the most common complication after esophageal stenting, 1 case had to receive airway stenting and 1 case received replacement of esophageal stent. During follow up, 23 patients were clinically cured, 2 patients were improved in symptoms, and 1 was invalid. Eight deaths were found in total. The 1-year, 3-year, and 5-year survival rates were 82.4%, 78.8%, and 78.8%, respectively. In conclusion, combined airway and esophageal stents implantation under fluoroscopy guidance and local anesthesia are safe and effective for malignant tracheobronchial and esophageal disease.
我们旨在评估在荧光镜引导和局部麻醉下,联合气道和食管支架置入术对恶性气管支气管和食管疾病患者的安全性和有效性。这项回顾性分析纳入了2012年3月至2016年8月期间连续接受联合支架置入术的35例患者。所有患者在支架置入前和随访期间均接受了胸部计算机断层扫描。共植入了39个气道支架和43个食管覆膜支架。收集并分析了支架置入的指征、技术成功率和介入后并发症。共植入了39个气道支架和43个食管覆膜支架。1个气道支架和2个食管支架置入失败,气道支架和食管支架的技术成功率分别为97.4%和95.3%。未发生与手术相关的死亡,仅1例患者因食管气管瘘呼吸衰竭死亡。两次支架置入的中位间隔时间为13.0天。支架置入后呼吸困难和吞咽困难均明显缓解。支架置入后再狭窄(7.7%)是气道支架置入最常见的并发症,所有这些病例均需要再次置入支架。支架移位(7.0%)是食管支架置入后最常见的并发症,1例患者不得不接受气道支架置入,1例患者接受了食管支架置换。随访期间,23例患者临床治愈,2例患者症状改善,1例无效。共发现8例死亡。1年、3年和5年生存率分别为82.4%、78.8%和78.8%。总之,在荧光镜引导和局部麻醉下联合气道和食管支架置入术对恶性气管支气管和食管疾病是安全有效的。