Messina Gaetana, Natale Giovanni, Pica Davide Gerardo, Vicario Giuseppe, Giorgiano Noemi Maria, Mirra Rosa, Di Filippo Vincenzo, Leonardi Beatrice, Capasso Francesca, Panini D'Alba Francesco, Vinciguerra Riccardo, Caputo Alessia, Puca Maria Antonietta, Pirozzi Mario, Balbo Ciro, Di Lorenzo Sara, Farese Stefano, Liguori Giovanni, Vicidomini Giovanni, Messina Giovanni, Fiorelli Alfonso, Ciardiello Fortunato, Fasano Morena
Thoracic Surgery Unit, Università̀ degli Studi della Campania "Luigi Vanvitelli", Naples, Campania, Italy.
Oncology, Department of Precision Medicine, Università della Campania "L. Vanvitelli", Naples, Campania, Italy.
Thorac Cancer. 2024 Dec;15(34):2428-2436. doi: 10.1111/1759-7714.15440. Epub 2024 Oct 21.
Self-expanding Y-metal stents (SEMS) are best suited lesions with involvement of the carina and proximal main bronchi; however, Y-stents can be difficult to place. These difficulties guided us to develop a modification of the classic technique that addresses some of the challenges during positioning. We present the Y reverse technique for Y stent insertion using a combination of rigid and flexible bronchoscopy.
This retrospective study included 15 consecutive patients, suffering from tracheal-carina-lower main bronchi complex, hospitalized at the Thoracic Surgery Unit of the Vanvitelli University of Naples between October 2021 and October 2023.
patients in which the length of the stenosis of the right bronchi was greater than that of the left bronchi, advanced oncological conditions, severe respiratory failure; exclusion criteria: Karnofsky scale with <40 points. All patients were admitted to the hospital and treated with Y-stent insertion using the modified technique Y reverse.
The comparison between the group undergoing the Y reverse technique with the group undergoing the traditional positioning of the Y prosthesis has shown an improvement in respiratory function; prolongation of the mean survival time; improvement in SpO in spontaneous breathing; reduction mean time procedure. p < 0.05 was considered as statistically significant.
Y Reverse is a safe and effective procedure that provides rapid symptom relief in individuals who have critical central airway obstruction near the distal portion of the trachea, carina, and main right and left bronchi.
自膨式Y形金属支架（SEMS）最适用于累及隆突和近端主支气管的病变；然而，Y形支架可能难以放置。这些困难促使我们对经典技术进行改进，以应对定位过程中的一些挑战。我们介绍了一种使用刚性和柔性支气管镜相结合的Y形支架置入Y反向技术。
这项回顾性研究纳入了2021年10月至2023年10月期间在那不勒斯维万泰利大学胸外科住院的15例连续性患者，他们患有气管-隆突-下主支气管复合体病变。
右支气管狭窄长度大于左支气管、晚期肿瘤病情、严重呼吸衰竭的患者；排除标准：卡诺夫斯基量表评分<40分。所有患者均入院并采用改良的Y反向技术进行Y形支架置入治疗。
采用Y反向技术的组与采用传统Y形假体定位的组相比，呼吸功能有所改善；平均生存时间延长；自主呼吸时SpO改善；手术平均时间缩短。p<0.05被认为具有统计学意义。
Y反向技术是一种安全有效的手术方法，可为气管远端、隆突以及左右主支气管附近严重中央气道阻塞的患者迅速缓解症状。
