Chen Yu, Zhou Zi-Qing, Feng Jia-Xin, Su Zhu-Quan, Zhong Chang-Hao, Lu Li-Ya, Chen Xiao-Bo, Tang Chun-Li, Digumarthy Subba R, Fiorelli Alfonso, Natour Ehsan, Lococo Filippo, Petrella Francesco, Harris Kassem, Nakada Takeo, Zhong Nan-Shan, Li Shi-Yue
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Transl Lung Cancer Res. 2021 May;10(5):2218-2228. doi: 10.21037/tlcr-21-353.
Airway stenting is frequently used in the palliative treatment of patients with advanced tumor-induced airway stenosis and fistulas. However, there is paucity of studies regarding the use of airway stents in restoring patency. The aim of the study was to assess the efficacy and safety of hybrid silicon Y stents and covered self-expanding metal stents (SEMS) and in reestablishing patency in airway stenoses and fistulas.
This retrospective study included 31 patients between January 2016 to December 2019 with inoperable complex malignant airway stenoses and fistulas, managed with Silicone Y stents, and covered SEMS. The clinical details, clinical outcomes and complications up to 6 months were extracted from medical records. The improvement of performance was assessed based on modified British Medical Research Council (mMRC) dyspnea scores (=6.892, P<0.001), Karnofsky Performance Scores (KPS) (=-11.653, P<0.001), and performance status (PS) (=3.503, P<0.001).
A total of 31 silicon Y stents and 35 covered SEMSs were inserted. Of the 31 patients (M:F 20:11; age: 54.64±9.57), 25/31 (80.6%) experienced immediate relief of symptoms following stent placement. Patients' mMRC dyspnea scores, KPS, and PS showed significant improvement following stenting. The mean duration of stent placement was 146.3±47.7 days, and 17/31 (55%) patients were alive at 6 months. No major complications related to hybrid stenting were observed during the follow-up period.
Hybrid stenting is a feasible and safe palliative treatment for malignant airway stenosis and fistulas to improve quality of life and can be performed without major complications.
气道支架置入术常用于晚期肿瘤所致气道狭窄和瘘管患者的姑息治疗。然而，关于气道支架恢复通畅性应用的研究较少。本研究旨在评估混合硅酮Y形支架和覆膜自膨式金属支架（SEMS）恢复气道狭窄和瘘管通畅性的有效性和安全性。
这项回顾性研究纳入了2016年1月至2019年12月期间31例患有无法手术的复杂性恶性气道狭窄和瘘管的患者，采用硅酮Y形支架和覆膜SEMS进行治疗。从病历中提取临床细节、临床结局和长达6个月的并发症情况。基于改良英国医学研究委员会（mMRC）呼吸困难评分（=6.892，P<0.001）、卡诺夫斯基功能状态评分（KPS）（=-11.653，P<0.001）和功能状态（PS）（=3.503，P<0.001）评估治疗效果。
共置入31个硅酮Y形支架和35个覆膜SEMS。31例患者（男:女为20:11；年龄：54.64±9.57）中，25/31（80.6%）在支架置入后症状立即缓解。支架置入后患者的mMRC呼吸困难评分、KPS和PS均有显著改善。支架置入的平均持续时间为146.3±47.7天，17/31（55%）的患者在6个月时存活。随访期间未观察到与混合支架置入相关的重大并发症。
混合支架置入术是一种可行且安全的恶性气道狭窄和瘘管姑息治疗方法，可改善生活质量，且不会出现重大并发症。
