Placement of tracheobronchial silicone Y-stents: Multicenter experience and systematic review of the literature
| Autor: | Rajiv Goyal, Ravindra M Mehta, Jayachandra Akkaraju, Karan Madan, Sahajal Dhooria, Inderpaul Singh Sehgal, Ritesh Agarwal, Vallandramam Pattabhiraman |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Tracheoesophageal fistula 030204 cardiovascular system & hematology Airway stent 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Silicone medicine cardiovascular diseases esophageal cancer Esophagus tracheal stenosis lcsh:RC705-779 business.industry Stent lcsh:Diseases of the respiratory system Airway obstruction respiratory system medicine.disease equipment and supplies Surgery Tracheal Stenosis lung cancer medicine.anatomical_structure surgical procedures operative 030228 respiratory system Respiratory failure chemistry central airway obstruction Original Article Airway business |
| Zdroj: | Lung India, Vol 34, Iss 4, Pp 311-317 (2017) Lung India : Official Organ of Indian Chest Society |
| ISSN: | 0970-2113 |
| Popis: | Background: Airway obstruction or tracheoesophageal fistula (TEF) near the tracheal carina requires placement of Y-shaped stents. Herein, we describe our multicenter experience with the placement of Dumon silicone Y-stents. We also conduct a systematic review for studies describing the deployment of airway silicone Y-stents. Methods: This was a retrospective analysis of consecutive subjects who underwent placement of silicone Y-stents. The clinical details including the underlying diagnosis, indication for the placement of silicone Y-stents, success of stent placement, and follow-up are presented. The PubMed and EMBASE databases were also reviewed for studies describing the placement of silicone Y-stents. Results: During the study, 27 silicone Y-stents were placed. The mean (standard deviation) age of the study population (85.2% males) was 57.7 (13.5) years. The stents were placed for airway obstruction in 77.8% and TEF in 29.6% of the patients. The most common underlying disease was carcinoma of the esophagus. The degree of airway obstruction was grade 3–4 in 18 subjects, and respiratory failure was encountered in 18 subjects. The stent was deployed successfully in all the subjects. No deaths were encountered during stent placement. Most subjects had rapid relief of symptoms following the procedure. Excessive secretions and mucostasis were the most common stent-related complications followed by the development of granulation tissue. The systematic review yielded nine studies (338 subjects with airway obstruction and/or TEF). The most common indication for silicone Y-stent placement was tracheobronchial obstruction and TEF due to malignancy. Benign disorders that necessitated stent placement included postintubation tracheal stenosis, airway malacia, and others. The stent was successfully placed in 98% with only one periprocedural death. Granulation tissue formation and mucostasis were the most common stent-related complications. Conclusion: Placement of silicone Y-stent is a safe and effective procedure that provides quick relief of symptoms in subjects presenting with airway obstruction and TEF at or near the tracheal carina. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|