Use of the Dumon Y-stent in the management of malignant disease involving the carina: a retrospective review of 86 patients.

OBJECTIVE

To study the efficacy of symptom relief and the safety of the Dumon Y-stent for central airway obstruction in malignant main carinal involvement and in malignant tracheoesophageal fistulas.

DESIGN

A retrospective review.

SETTING

Thoracic endoscopy referral center.

PATIENTS AND

METHODS

The medical records of 86 patients who had undergone the placement of a Dumon Y-stent at our institution were reviewed and analyzed.

RESULTS

Ninety Dumon Y-stents were placed in 86 patients to relieve symptoms of dyspnea, cough, and/or hemoptysis. Four of these patients required removal of that stent and replacement with a longer Dumon Y-stent due to tumor progression. There were only two instances of procedure-related adverse effects, which included coughing following stent placement lasting 1 week in one patient and stent migration in another patient. In the case of stent migration, the stent required immediate removal, and the patient experienced no adverse consequences. The remaining patients tolerated the stent well, and all experienced subjective symptomatic relief. There were no stent-related deaths. The average duration of a stent after placement was 133 days. The median time of survival following stent insertion was 181 days. Forty-five percent of all patients died at 3 months, and 72% died at 6 months.

CONCLUSION

The Dumon Y-stent proved to be useful and was well-tolerated in the management of malignant disease involving the main carina. It also provided successful palliation in patients with malignant tracheoesophageal fistulas.