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Ann Thorac Surg ; 111(1): 283-289, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32589886

RESUMO

BACKGROUND: Airway stenting to restore airway patency in cases of malignant central airway obstruction is an effective palliation treatment. Our goal was to compare the efficacy after deployment and complications of a fully covered self-expandable metal stent (SEMS) (Aerstent) and a silicone stent (Dumon). METHODS: This was a retrospective cohort of 2 similar groups of patients with malignant central airway obstruction treated with stents between August 2012 and July 2017. Complications were assessed bronchoscopically. A competing risk for death analysis was performed to adjust the probability of developing a complication. RESULTS: Seventy patients (29 with silicone stents and 41 with SEMS) were included. Stent insertion was successful in all cases. Mucus retention was the most frequent complication (75.9% with silicone stents and 84.8% with SEMS; P = .51), followed by granulation tissue (51.7% with silicone stents and 41.3% with SEMS; P = .52) and migration (6.9% with silicone stents and 13.0% with SEMS; P = .47). In the first month, the cumulative incidence of a complication was 36.7% for silicone stents and 41.3% for SEMS and increased to 90.0% and 97.8% after 6 months, respectively (hazard ratio = 1.66; P = .04). A competing risk for death analysis showed an adjusted hazard ratio of 1.41 (P = .49) indicating no differences in overall complications between stents. CONCLUSIONS: Both stents were equally successful and safe. The incidence of complications increased over time to 90% at 6 months for both stents. The risk of overall complications was higher for SEMS; nevertheless, when mortality was measured in a competitive risk analysis, no differences were found between SEMS and silicone stents.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/cirurgia , Neoplasias do Sistema Respiratório/complicações , Stents , Idoso , Estudos de Coortes , Constrição Patológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Desenho de Prótese , Estudos Retrospectivos , Medição de Risco , Stents Metálicos Autoexpansíveis/efeitos adversos , Silicones , Stents/efeitos adversos
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