Long-term Outcome of Short Metallic Stents for Lobar Airway Stenosis
Long-term Outcome of Short Metallic Stents for Lobar Airway Stenosis
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DOI：
10.1097/lbr.0000000000000371
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发表时间：
2017-07-01
影响因子：
3.3
通讯作者：
Kramer, Mordechai R.
中科院分区：
文献类型：
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作者：
Fruchter, Oren;El Raouf, Bayya Abed;Kramer, Mordechai R.
背景资料：尽管支架被认为是近端中央主要气道狭窄的良好治疗方法，但支架治疗远端肺叶气道狭窄的价值仍存在争议。我们的目的是探讨放置金属支架治疗良性和恶性肺叶气道狭窄的短期和长期结局。方法：2007年7月至2014年7月，14例患者接受了小气道支架植入术。临床随访包括一系列半年一次的体格检查、肺功能检查、影像学检查和支气管镜检查。肺移植后早期支气管狭窄（N=5）、结节病（N=1）、淀粉样变性（N = 1）、炭疽纤维化（N = 1）、外淋巴结压迫所致右中叶综合征（N= 1）、肺癌（N= 4），左肺上叶狭窄，病因不明（N=1）。支架置入右上叶支气管（N=2）、右中叶支气管（N= 6）、左上叶支气管（N=4）、舌支气管（N=1）和左下叶支气管（N= 1）。中位随访时间为2至72个月（中位18个月）。绝大多数患者（13/14，92%）的症状立即缓解。在10例良性病因狭窄，9（90%）经历了持续和渐进的改善肺功能测试和临床conditions.Conclusions：我们描述了我们的积极经验与小支架肺叶气道狭窄，需要进一步的前瞻性试验，以评估这种新的治疗方式的价值。
Background: Whereas stents are considered an excellent treatment for proximal central major airway stenosis, the value of stenting for distal lobar airway stenosis is still controversial. Our aim was to explore the short-term and long-term outcome of metallic stents placed for benign and malignant lobar airway stenosis.Methods: Between July 2007 and July 2014, 14 patients underwent small airway stent insertion. The clinical follow-up included serial semiannual physical examinations, pulmonary function tests, imaging, and bronchoscopy.Results: The etiologies for airway stenosis were: early post-lung transplantation bronchial stenosis (N=5), sarcoidosis (N=1), amyloidosis (N=1), anthracofibrosis (N=1), right middle lobe syndrome due to external lymph node compression (N= 1), lung cancer (N= 4), and stenosis of the left upper lobe of unknown etiology (N=1). Stents were placed in the right upper lobe bronchus (N=2), right middle lobe bronchus (N= 6), left upper lobe bronchus (N=4), linguar bronchus (N=1), and left lower lobe bronchus (N= 1). The median follow-up period ranged from 2 to 72 months (median 18 mo). Immediate relief of symptoms was achieved in the vast majority of patients (13/14, 92%). Out of 10 patients with benign etiology for stenosis, 9 (90%) experienced sustained and progressive improvement in pulmonary function tests and clinical condition.Conclusions: We describe our positive experience with small stents for lobar airway stenosis; further prospective trials are required to evaluate the value of this novel modality of treatment.