Double stents indwelling in malignant tracheal and esophageal stenosis

Objective To evaluate the efficacy and safety of double stents indwelling in the treatment for malignant tracheal and esophageal stenosis.Methods Twelve patients with inoperable malignant tracheal bronchial and esophageal stenosis, male 8, female 4, aged 38-66 years, mean age 48.8 years, were indwelled stents by fluoroscopic guidance.Seven cases with dysphagia as the main symptom were implanted esophageal stents firstly and then tracheal bronchial stents.Five cases dysponea as the main symptom were implanted tracheal bronchial stents firstly and then esophageal stents.The nickle titanium coated stents were chosen for esophageal stenosis and self-expanding nitinol stents for tracheal bronchial stenosis.Results All tracheal bronchial and esophageal stents were successful implanted and well-tolerated in all patients.Suffocation appered immediately in 5 cases after esophageal stents implantation and dyspnea appeared in 2 cases within 24 hours due to tracheal compression in those esophageal stents were implanted firstly, and whose dyspnea and suffocation were immediately relieved after the tracheal bronchial stents implantation.Two cases with esophago-tracheal fistula were cured after double stents were implanted.The postoperative survival period of all patients were 1.5 months to 6.2 months(mean 3.4 months) after stent implantation.Dysphagia reoccurred in 1 case due to tumor overgrowth and relieved after another stent implantation.Conclusion Double stents indwelling is safe and effective approach in patients with malignant tracheal bronchial and esophageal stenosis.These results demonstrate that tracheal bronchial stents should be implanted firstly and then esophageal stents be implanted to avoid suffocation due to tracheal bronchial compression by the esophageal stent.