Use of Studded Polyflex™ Stents in Patients with Neoplastic Obstructions of the Central Airways
Date
2004
Authors
Bolliger C.T.
Breitenbuecher A.
Brutsche M.
Heitz M.
Stanzel F.
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Abstract
Background: The Polyflex™ is a commercially available silastic airway stent with proven efficacy. Due to a smooth outer surface its anchorage in the airway wall is superficial which may lead to stent migration. Objective: To study the performance of an newer version of the Polyflex stent with a studded outer surface, which should improve anchorage. Methods: In a 5-centre international study the new stent was prospectively tested in symptomatic patients with neoplastic central airway stenosis of more that 50% of normal diameter. Insertion technique, efficacy of stent placement and stent-related complications were recorded before, 1 month and 3 months post stent placement. Results: Under general anaesthesia and rigid bronchoscopy 27 stents were inserted in 26 patients, mean age: 62 years (range: 37-83), 16 men. Diagnoses were 18 bronchogenic carcinoma, 4 oesophageal carcinoma, 2 metastases, 1 tracheal carcinoma, and 1 schwannoma. The stents were inserted in the following locations: 10 right main bronchus, 8 left main bronchus, 7 trachea, and 2 tracheo-bronchial. There was significant improvement in all functional parameters assessed from before (A), to 1 month (B) and 3 months (C) after stent placement. The measured values (mean ± SD) were for the WHO scale: A: 2.7 (0.8), B: 1.5 (0.9), C: 1.6 (1.0); for the Karnofsky scale: A: 44 (19), B: 72 (18), C: 71 (21); for the Dyspnoea Index: A: 3.3 (0.7), B: 1.5 (0.8), C: 1.9 (1.2); for FEV1: A: 1.2 (0.5), B: 1.9 (0.6), C: 1.5 (0.5), and for FVC: A: 2.1 (0.7), B: 2.8 (0.7), C: 2.5 (1.0). Stent-related complications were 4 reversible stent obstructions by secretions, 1 migration. The observation period was mean 4.3 months (range 2 days to 23 months). Conclusion: The studded Polyflex showed excellent efficacy, was very well tolerated, and had a very low migration rate. It presents an improvement over the older smooth model and can be considered a true alternative to the most widely used silastic stent, the Dumon stent. Copyright © 2004 S. Karger AG, Basel.
Description
Keywords
ampicillin, baysilon, dimeticone, silicone derivative, adult, aged, airway obstruction, article, bronchoscopy, bronchus, clinical article, clinical trial, esophagus carcinoma, female, follow up, general anesthesia, human, lung function, lung non small cell cancer, lung small cell cancer, male, metastasis, multicenter study, neurilemoma, postoperative complication, priority journal, rating scale, respiratory tract cancer, secretion, stent, trachea, trachea carcinoma, tracheobronchial tree, treatment outcome, comparative study, esophagus tumor, international cooperation, lung tumor, methodology, middle aged, palliative therapy, pathology, prognosis, prospective study, prosthesis, quality of life, risk assessment, trachea tumor, Adult, Aged, Aged, 80 and over, Airway Obstruction, Bronchoscopy, Dimethylpolysiloxanes, Esophageal Neoplasms, Female, Humans, International Cooperation, Lung Neoplasms, Male, Middle Aged, Palliative Care, Prognosis, Prospective Studies, Prosthesis Design, Quality of Life, Risk Assessment, Silicones, Stents, Tracheal Neoplasms, Treatment Outcome
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