2007 Volume 29 Issue 1 Pages 30-37
The original purpose of airway stents is to maintain the lumen by dilating sites of stenosis. However, stents can also be modified for applications in standard surgical treatments. For example, in cases of airway reconstruction for infiltration of thyroid cancer into the trachea in which extensive airway resection is necessary, the application of internal stents enables patch graft reconstruction and eliminates the need for segmental resection, thus reducing operative stress and risks. Following this procedure, patients require only outpatient visits during the course of the development cicatricial formation. In cases of infiltration of esophageal and lung cancer into the airway, the use of stents improves dyspnea caused by airway stenosis and dysphagia caused by tracheoesophageal fistula, and thus enables subsequent radiation therapy and chemotherapy. Patients who underwent these treatments demonstrated a survival advantage of 3 months while maintaining their QOL. In addition, the use of a Y-shaped silicone stent in which one end was modified and closed enables maintenance of the airway of healthy lungs by inhibiting the spread of tumors from the main bronchi into the trachea, and promotes granulation in cases of post-pneumonectomy bronchial stump fistula by reducing air fistula. In cases of stenosis caused by tumor infiltration or compression from outside of the airway wall, stent diameter must be selected on a millimeter scale in order to ensure airway maintenance without excessive dilatation. Bronchoscopic ultrasound enables measurements of the internal diameter of the dilated airway in addition to observations of the structure of the tracheal wall and the condition of areas surrounding the airway, and is thus essential for preventing granulation, perforation, and migration of stents. (JJSRE. 2007;29:30-37)
