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Research
Tracheobronchial stents in palliative care: a case series and literature review
  1. Richard Tjahjono1,2,
  2. Ronald Yoon-Kong Chin1,2,3 and
  3. Peter Flynn2,4
  1. 1 Department of Otolaryngology Head and Neck surgery, Nepean Hospital, Sydney, New South Wales, Australia
  2. 2 Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Faculty of Medicine, Western Sydney University, Penrith, New South Wales, Australia
  4. 4 Department of Thoracic Surgery, Nepean Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Professor Ronald Yoon-Kong Chin, Department of Otolaryngology Head and Neck Surgery, The University of Sydney, Camperdown NSW 2006, Australia; aprof.chin{at}gmail.com

Abstract

Objective To evaluate the outcomes of tracheobronchial stenting in patients with malignant central airway obstruction and assist practitioners in palliative settings in understanding the indications, contraindications and management of tracheobronchial stents.

Methods This retrospective study involved a consecutive case series of palliative patients with central airway obstruction secondary to inoperable cancers who underwent tracheobronchial stenting at a single institution. The European Cooperative Oncology Group (ECOG) scale was used to evaluate patient functional status before and after tracheobronchial stenting.

Results Twenty-three patients underwent tracheobronchial stenting for malignant central airway obstruction. The majority of patients presented with symptoms of worsening dyspnoea (21 of 23; 91%). Postoperatively, there was a significant improvement in mean ECOG performance status from 2.88±0.34 to 1.58±0.50 (p<0.01). There was no intraoperative mortality resulting from tracheobronchial stenting. Five patients (21.74%) re-presented to hospital due to worsening symptoms and required emergency bronchoscopy. Two patients had stent migration, requiring stent replacement. One patient restenosed from tumour granulation, requiring microdebrider to debulk the mass. Two patients had stent failure secondary to external tumour compression, leading to death.

Conclusion Tracheobronchial stenting is a safe and effective procedure that offers rapid palliation of symptoms and improvement in patient functional status.

  • head and neck
  • quality of life
  • supportive care
  • dyspnoea
  • tracheobronchial stent

https://doi.org/10.1136/bmjspcare-2018-001522

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    Footnotes

    • Contributors RT and RYC contributed to the conception and design. RT, RYC and PF contributed to the interpretation and manuscript writing. RYC was responsible for the final approval of the article.

    • Funding This study was funded by the Department of Otolaryngology, Nepean Hospital, Sydney, Australia for the purposes of ethics application and data collection.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Nepean Blue Mountains Local Health District Human Research Ethics Committee (LNR/18/NEPEAN/16) .

    • Provenance and peer review Not commissioned; externally peer reviewed.