Indications and clinical outcomes of fully covered self-expandable metallic tracheobronchial stents in patients with malignant airway diseases

Abstract

ABSTRACT Background Airway stenting is an efficacious approach in management of malignant airway disease (MAD) with improvement in survival outcome. Objective To determine the indications and long-term clinical outcomes of tracheobronchial stenting in patients with MAD. Methods A cross-sectional review of 51 patients who underwent airway stenting from June 2011 to June 2019 was done. Paired t-test was used to compare mean difference of clinical characteristics between pre- and post-airway stenting. Kaplan–Meier curves were used to assess overall survival. Results A total of 51 patients had stent insertion with mean age 46.63±17.10years including 27(52.9%) females. Mainly 37(72.5%) patients had esophageal and 06(11.8%) had lung cancer. The main indications were bronchial stenosis 18(35.3%), tracheal stenosis 11(21.6%) and Tracheo-esophageal/bronchial fistula 13(25.5%). Obstruction was intrinsic, extrinsic and mixed in 20(39.2%), 13(25.5%) and 5(9.8%) patients, respectively. There was statistically significant mean difference in pre- and post-procedure oxygen saturation (mean (M)=89.8, standard deviation (SD)=6.70 vs M =95.5,SD=2.54.p =0.001) and performance status (M =3.65,SD =0.6 vs M =2.59, SD=0.83.p =0.001). Overall median survival was 16±3.44 weeks, highest amongst patients with intrinsic obstruction (27±6.51 weeks). Conclusion Airway stenting is an effective endoscopic procedure to re-establish airway patency in MAD with minimal complications..