Experience and literature review of Y-type silicone tracheal stent in management of malignant tracheoesophageal fistula

Abstract

Objective To investigate the placement technique of Y-type silicone stent and related issue of tracheoesophageal fistula (TEF) treatment. Methods To review the case with TEF treated by Y-type Dumon stent in our hospital, the preparation for procedure, the effect and the related issues of Y-type Dumon stent for TEF was summarized. Results Diameter of the tracheal and TEF was measured according to CT and the diameter of Y-type Dumon stent (transverse diameter+ longitudinal diameter/2) was decided.Then the grinded Y-type Dumon stent was placed to the appropriate position by pushing device through rigid bronchoscopy during high frequency ventilation.Flexible bronchoscopy was used to help adjust the position of stent.No complication was found.After procedure, long term follow-up with bronchoscope and inhalation of normal saline with or without some expectorants was recommended. Conclusions TEF located around carina treated with Y-type Dumon stent is effective and safe.To assess the diseases carefully with a good work team and select an appropriate size of stent are all essential factors for successful Y-type silicone stent placement.The follow-up and management of airway after procedure are also very important for preventing the complications. Key words: Y-type Dumon silicone stent; Tracheoesophageal fistula; Rigid bronchoscopy; Interventional pulmonology