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Clinical outcomes of self-expandable metallic stents for malignant obstructive atelectasis.
Scientific Reports ( IF 3.8 ) Pub Date : 2020-02-27 , DOI: 10.1038/s41598-020-60566-6
Yonghua Bi 1 , Xiaoyan Zhu 2 , Zepeng Yu 1 , Mengfei Yi 1 , Xinwei Han 1 , Jianzhuang Ren 1
Scientific Reports ( IF 3.8 ) Pub Date : 2020-02-27 , DOI: 10.1038/s41598-020-60566-6
Yonghua Bi 1 , Xiaoyan Zhu 2 , Zepeng Yu 1 , Mengfei Yi 1 , Xinwei Han 1 , Jianzhuang Ren 1
Affiliation
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Self-expandable metallic stents (SEMSs) have been widely used in the treatment of malignant central airway obstruction. However, few reports focus on the treatment of atelectasis and how to estimate the prior probability of success via SEMSs placement, This current study aimed to study the safety and effectiveness of SEMSs for the treatment of obstructive atelectasis, and the value of preoperative CT enhancement for ventilation of atelectasis via SEMSs placement. A total of 35 patients with obstructive atelectasis (29 male and 6 female) was included from February 2012 to March 2018. The procedures were performed under fluoroscopic guidance, and bronchoscopic laser resection was performed for severe restenosis cases after SEMSs placement. Clinical and functional pulmonary data were recorded before and 3 months after the procedure. Follow-up involved clinical data and radiographic techniques at 48 h and at 1-, 3-, 6-, and 12-month intervals. Thirty-eight SEMSs were successfully implanted in 34 patients, included 29 Y type tracheal stents, 4 small y stents, and 5 straight airway stents. After stenting, 26 cases showed full ventilation, and 3 cases were partially ventilated. The technical success and clinical success was 97.1% and 82.9%, respectively. A higher maximum enhancement CT value was found in patients with full ventilation. Mean follow-up time was 18.8 ± 4.0 months. Eight cases showed restenosis and received endoscopic laser resection, included 1 case underwent removal and 3 cases received second stenting. There were 2 cases of perioperative non-operative death, and 11 cases of post-discharge death (2 cardiac deaths and 9 malignant tumors). The survival rates of 3 months, 1 year and 2 years were 78.6%, 58.5% and 58.5%, respectively. In conclusion, SEMSs placement is safe and effective for obstructive atelectasis, and the preoperative CT enhancement played an important role in estimating the prior probability of success in the treatment of atelectasis via SEMSs placement.
中文翻译：
自膨胀金属支架治疗恶性阻塞性肺不张的临床疗效。
自膨胀金属支架（SEMSs）已广泛用于治疗恶性中央气道阻塞。但是，很少有报道关注肺不张的治疗以及如何通过SEMS放置来评估先前的成功可能性。本研究旨在研究SEMS在阻塞性肺不张的治疗中的安全性和有效性，以及术前CT增强治疗的价值。通过SEMS放置肺不张通气。从2012年2月至2018年3月，共纳入35例梗阻性肺不张患者（男29例，女6例）。该手术在荧光镜引导下进行，对于放置了SEMS的严重再狭窄病例行支气管镜激光切除。在手术前和手术后3个月记录临床和功能肺数据。随访时间为48小时，1、3、6和12个月，包括临床数据和放射照相技术。38例成功植入38例SEMS，包括29根Y型气管支架，4根小y支架和5根直气道支架。支架置入后26例显示完全通气，3例部分通气。技术成功率和临床成功率分别为97.1％和82.9％。在完全通气的患者中发现更高的最大增强CT值。平均随访时间为18.8±4.0个月。8例表现为再狭窄并接受内镜激光切除，其中1例进行了切除，3例进行了第二次支架置入。围手术期非手术死亡2例，出院后死亡11例（心脏死亡2例，恶性肿瘤9例）。3个月，1年和2年的存活率分别为78.6％，58.5％和58.5％。总之，SEMS的置入对于阻塞性肺不张是安全有效的，术前CT增强在评估通过SEMS置入治疗肺不张的成功可能性方面起着重要作用。
更新日期：2020-02-27
中文翻译：
自膨胀金属支架治疗恶性阻塞性肺不张的临床疗效。
自膨胀金属支架（SEMSs）已广泛用于治疗恶性中央气道阻塞。但是，很少有报道关注肺不张的治疗以及如何通过SEMS放置来评估先前的成功可能性。本研究旨在研究SEMS在阻塞性肺不张的治疗中的安全性和有效性，以及术前CT增强治疗的价值。通过SEMS放置肺不张通气。从2012年2月至2018年3月，共纳入35例梗阻性肺不张患者（男29例，女6例）。该手术在荧光镜引导下进行，对于放置了SEMS的严重再狭窄病例行支气管镜激光切除。在手术前和手术后3个月记录临床和功能肺数据。随访时间为48小时，1、3、6和12个月，包括临床数据和放射照相技术。38例成功植入38例SEMS，包括29根Y型气管支架，4根小y支架和5根直气道支架。支架置入后26例显示完全通气，3例部分通气。技术成功率和临床成功率分别为97.1％和82.9％。在完全通气的患者中发现更高的最大增强CT值。平均随访时间为18.8±4.0个月。8例表现为再狭窄并接受内镜激光切除，其中1例进行了切除，3例进行了第二次支架置入。围手术期非手术死亡2例，出院后死亡11例（心脏死亡2例，恶性肿瘤9例）。3个月，1年和2年的存活率分别为78.6％，58.5％和58.5％。总之，SEMS的置入对于阻塞性肺不张是安全有效的，术前CT增强在评估通过SEMS置入治疗肺不张的成功可能性方面起着重要作用。
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