気道・食道のステント治療 気管・気管支のステント治療 特に高度気道狭窄における複数個のステント留置（ｃｏｍｂｉｎａｔｉｏｎ ｓｔｅｎｔｉｎｇ）について

Abstract

Further implantation of the same stent and/or additional implantation of a different stent are sometimes needed during therapeutic bronchoscopy. Therefore, combination stenting has been performed using a rigid bronchoscope as an emergency procedure in 23 patients with life-threatening tracheobronchial stenosis (11 lung cancers, 9 esophageal cancers, 1 colon cancer, 1 relapsing polychondritis, and 1 von Recklinghausen's disease). This treatment has been performed with combination stents of many types (19 Dumon stents including 6 Dumon Y-stents, 47 Ultraflex stents, 1 Dynamic stent, and 2 Covered Wallstents). Symptomatic relief of dyspnea was achieved in 87% of the patients. Due to the diffuse narrowing of the airway extending along the trachea into the mainstem bronchi and beyond, in one patient seven stents had to be implanted, six stents in one patients, five stents in one patient, and four in two others. Due to stenosis with fistula, in one patient three stents had to be implanted, and two in four others. Combination stenting should be considered in some cases. This procedure seems to be indicated in certain complicated situations, e.g., long stenosis, bilateral bronchial stenoses, and stenosis with fistula.