The Use of the Covered Wallstent for the Palliative Treatment of Inoperable Tracheobronchial Cancers

Monnier, Philippe; Mudry, Albert; Stanzel, Franz; Haeußinger, Karl; Heitz, Markus; Probst, Rudolf; Bolliger, Chris T.

doi:10.1378/chest.110.5.1161

Cited by 122 publications

(72 citation statements)

References 23 publications

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“…There is no clear advantage of any type of stent [88,89,91,92,95,[98][99][100][101][102][103][104]. Stents can be used temporarily [92,105] in a multimodality concept of cancer care and as a last palliative measure for end-stage cancer patients [106,107].…”

Section: Clinical Experience and Resultsmentioning

confidence: 99%

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Bolliger¹

2006

Eur Respir J

339

276

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Minimally invasive diagnostic and therapeutic approaches in medicine have been applied for a more selective and tailored approach to reduce patients' morbidity and mortality. The efficacy of interventional pulmonology for palliation of patients with central airways obstruction has been established and its curative potential for intralesional treatment of early cancer has raised great interest in current screening programmes. This is due to the fact that surgical resection and systemic nodal dissection as the gold standard is relatively morbid and risky, especially when dealing with individuals with limited functional reserves due to smoking-related comorbidities, such as chronic obstructive pulmonary disease. Furthermore, such comorbidities have been proven to harbour early stage lesions of several millimetres in size without involvement of nodal disease that may be amenable to local bronchoscopic treatment.Therefore, the success of minimally invasive strategies for palliation and treatment with curative intent strongly depends on the diligent identification of the various factors in lung cancer management, including full comprehension of the limits and potential of each particular technique. Maximal preservation of quality of life is a prerequisite in successfully dealing with individuals at risk of harbouring asymptomatic early lung cancer, to prevent aggressive surgical diagnostic and therapeutic strategies since overdiagnosis remains an issue that is heavily debated.In the palliative setting of alleviating central airway obstruction, laser resection, electrocautery, argon plasma coagulation and stenting are techniques that can provide immediate relief, in contrast to cryotherapy, brachytherapy and photodynamic therapy with delayed effects. With curative intent, intraluminal techniques that easily coagulate early stage cancer lesions will increase the implementation of interventional pulmonology for benign and relatively benign diseases, as well as early cancer lesions and its precursors at their earliest stage of disease.

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Section: Clinical Experience and Resultsmentioning

confidence: 99%

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Bolliger¹

2006

Eur Respir J

339

276

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“…In a series of 40 patients with MAO, the severe dyspnea index improved in 34 of 39 patients within 24 h of stent insertion [130]. In patients with acute respiratory failure due to malignant MAO requiring mechanical ventilation, stenting is associated with weaning from ventilatory support.…”

Section: Airway Stentsmentioning

confidence: 99%

Bronchoscopic Management of Malignant Airway Obstruction

Mitchell

Kennedy

2014

Adv Ther

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Approximately one-third of patients with lung cancer will develop airway obstruction and many cancers lead to airway obstruction through metastases. The treatment of malignant airway obstruction is often a multimodality approach and is usually performed for palliation of symptoms in advanced lung cancer. Removal of airway obstruction is associated with improvement in symptoms, quality of life, and lung function. Patient selection should exclude patients with short life expectancy, limited symptoms, and an inability to visualize beyond the obstruction. This review outlines both the immediate and delayed bronchoscopic effect options for the removal of airway obstruction and preservation of airway patency with endobronchial stenting.

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“…With time, these stents may become embedded in airway mucosa, rendering them extremely difficult to remove. In one study, the late complications observed included stent migration (12 %), inflammatory granulation or tumor regrowth (36 %), and symptomatic retention of secretions (38 %) [28].…”

Section: Self-expanding Stents (Sems)mentioning

confidence: 99%

Metallic stents in the airway: should we continue to use them and can we remove them?

Michaud

2012

Curr Respir Care Rep

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Metallic stents have proven to be valuable tools for the management of both malignant and benign airway obstruction. Their use has become popular worldwide as has our knowledge of their long-term effects on the airway. It is essential to understand the implications of placing a metallic stent since they are not devoid of potentially significant complications. It is also important to acknowledge that metallic stents are not always easily removed and a lack of familiarity with the complexities of their removal can have serious consequences. In general, their use should be reserved for malignant airway obstruction or in rare cases of benign disease where all other options have been ruled out.

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The Use of the Covered Wallstent for the Palliative Treatment of Inoperable Tracheobronchial Cancers

Cited by 122 publications

References 23 publications

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents

Bronchoscopic Management of Malignant Airway Obstruction

Metallic stents in the airway: should we continue to use them and can we remove them?

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