Abstract
Expandable metallic stents (EMS) were employed in cases of neoplastic tracheobronchial stenosis and the subsequent quality of life (QOL) of the patients and incidence of complications were evaluated. All 8 patients, 7 with primary lung cancer and 1 with tracheal invasion due to recurrent esophageal carcinoma, had received chemotherapy and/or radiotherapy prior to EMS placement because they were inoperable. We first performed tracheal intubation under local anesthesia and then placed Gianturco type EMS at the site of their stenotic lesions via flexible bronchoscopy under fluoroscopic guidance. We found that 1) dyspnea (Hugh-Jones IV or more) in 3 cases remarkably decreased immediately after EMS placement, 2) chemotherapy and/or radiotherapy were safely performed in 6 cases with the tracheobronchial tree remaining open after placement, 3) there were few life-threatening complications except one case of EMS migration out of his body with mild hemosputum, 4) Pseudomonas aeruginosa and Klebsiella pneumoniae from areas surrounding EMS in relatively long-term survivors were found, 5) EMS placement should contribute to the QOL of patients with neoplastic tracheobronchial stenosis if EMS can be successfully employed in selected patients.
