Clinical benefits and complications of Dumon stent insertion for the treatment of severe central airway stenosis or airway fistula

Abstract

The purpose of this study was to evaluate the clinical benefits and complications of Dumon stent insertion for patients with central airway disorders including stenosis and fistula. This was a retrospective analysis of medical records regarding alleviation of symptoms, occurrence of complications, and technical problems. Since August 1998, the Dumon stent has been used in 35 consecutive patients, included 24 with malignant airway stenosis, 5 with benign stenosis, and 6 with airway fistula. Altogether, 7 patients had a straight stent inserted into the trachea, 17 had a Y-stent inserted into the carina, and 11 patients had a straight stent inserted into the bronchus. In 33 of the 35 patients, the symptoms dramatically diminished after stent insertion. Poststenting complications included increased coughing in 37% of the patients, an obstruction of the stent due to secretion in 8.6%, migration in 5.7%, granulation in 2.9%, and cerebral infarction in 2.9%. Ten patients had the stent removed for various reasons, and five of the ten underwent reinsertion of a new stent. Migration could be avoided by external fixation with nylon threads in the upper trachea. Three of six patients with an airway fistula showed resolution of the fistula, and the remaining three patients improved symptomatically. Five of these six patients had undergone radiotherapy prior to stent insertion. The Dumon stent was found to be effective for treating not only airway stenosis but also airway fistula, with permissible complications. The Dumon stent is therefore considered to be the most effective airway stent presently available worldwide based on both cost and safety factors.