TEMPORARY TRACHEOBRONCHIAL STENTING IN MALIGNANT STENOSES

Endobronchial stent implantation has been successfully employed in mal ignant stenoses. The aim of this prospective study was to investigate the temporary use of tracheobronchial stents combined with tumour-spec ific therapy. All patients received stents for primary palliation of d yspnoea followed by radio- or chemotherapy with the aim of stent remov al after reduction of the stenosis. In 22 patients suffering from seve re malignant strictures, 34 endobronchial stents (29 Strecker-, 3 Dumo n-, 1 Orlowski-, 1 Dynamic-Y-stents) were implanted (in 9 patients, 2 stents were necessary). Patients were treated by irradiation (n = 18) or chemotherapy (n = 4) after stent implantation. Significant improvem ent of dyspnoea (P < 0.001) and partial oxygen pressure (P < 0.01) was observed. In 11 out of 22 cases (50%), the stents could be removed af ter successful tumour-specific therapy which led to reduction of steno sis after a mean interval of 31.7 (6-104) days (temporary stenting). D uring the period of tumour-specific therapy, 9 patients died after a m ean interval of 132 (13-347) days (definite stenting). In two cases, s tents had to be removed after stent compression, stent dislocation and severe cough. The results suggest that temporary stenting, characteri sed by subsequent successful tumour-specific therapy, is a new valuabl e therapeutic strategy. It can ''bridge the gap'' before tumour-specif ic therapy can take effect. If tumour-specific therapy is ineffective, definite stenting is the palliative method of choice in severe dyspno ea in bronchial carcinoma. (C) 1997 Elsevier Science Ltd.