VIDEO-ASSISTED INTERVENTIONAL BRONCHOSCOPY - THE HONG-KONG EXPERIENCE

Background: Major airway obstruction due to benign or malignant etiolo gy is not uncommon and is always distressing. Intraluminal stenting ha s been shown to be a safe and effective approach for symptomatic relie f in selected patients based on the European and North American experi ence, Methods: We reviewed our experience in Hong Kong on airway stent ing over a 19-month period. Results: From February 1994 to August 1995 , 33 silicone stents (Dumon stent, Cometh, Marseille, France) were pla ced in 23 patients (20 males, three females with mean age 61.4 years, range from 26 to 81). Eighteen stents were placed in the trachea, nine in the left main stem, five in the right main stem, and one Y-stent o ver the carina. Twelve patients had esophageal carcinoma involving the airway, seven had bronchial carcinoma, one had metastatic carcinoma, and three had benign strictures (of which two were due to tuberculosis ). There was no procedural related mortality. Stent migration occurred in four patients (17%) and required stent change. Symptoms were impro ved in all patients as documented by the visual analogue scale. Conclu sion: Our experience represents the ''stentable'' diseases seen in Hon g Kong, where carcinoma of the esophagus (and tuberculosis) remains pr evalent. We conclude that intraluminal stenting remains a safe and eff ective approach in selected patients with critical airway stenosis. Co mplications, however, do exist and should be realized by the operator, the patients, and their families.