[Tracheobronchial stenting in patients with non-resectable tumors complicated by airway stenosis]. / Endoskopicheskoe stentirovanie trakheobronkhial'nogo dereva u patsientov so stenoziruyushchei nerezektabel'noi opukhol'yu.

OBJECTIVE: To study the results and efficiency of tracheobronchial stenting in patients with unresectable tumors complicated by stenosis of central airways. MATERIAL AND METHODS: We analyzed the results of tracheobronchial stenting in 23 patients with unresectable tumors complicated by stenosis of central airways between 2016 and 2021. RESULTS: Technical and clinical success rate was 100%. No intraoperative complications were noted. Dyspnea regressed in all patients in early postoperative period. Moreover, there was objective improvement in lung ventilation with increase in lung capacity (from 2.1±0.4 to 2.7±0.5 l; p<0.05), forced expiratory volume (from 1.2±0.5 to 1.8±0.4 l; p<0.05), partial pressure of oxygen in arterial blood (from 47±7.4 to 85±6.3 mm Hg; p<0.05) and arterial oxygen saturation (from 86.1±8.2 to 93.1±5.1%; p<0.05). One patient developed massive bleeding due to tumor decay on the 3rd day after surgery. In 2 patients, stent obturation with a «mucus plug¼ was observed after 2-3 postoperative days. In 3 months after surgery, 21.8% of patients had disturbances of external respiration accompanied by mild dyspnea due to granulation tissue growth. Stent migration in 3 months after endoscopic stenting was recorded in 1 patient. Three-month mortality was 26.1%. CONCLUSION: Tracheobronchial stenting is a safe and effective minimally invasive surgical intervention. As a part of palliative care, this procedure improves functional and clinical parameters of pulmonary ventilation and reduces the incidence of complications. Thus, quality of life in patients with unresectable tumors complicated by airway stenosis is improved.

[Technical features of esophageal stent deployment]. / Tekhnicheskie osobennosti ustanovki pishchevodnykh stentov v zavisimosti ot tipa dostavochnogo ustroistva.

OBJECTIVE: To work out the optimal technique of endoscopic stenting of the esophagus (ESE) using various delivery devices (DD); to analyze immediate and long-term results of stenting depending on the type of DD. MATERIAL AND METHODS: ESE results were studied in 83 patients. Group 1 included 41 patients with implantation of metal stents delivered on a knitted tubular casing (21 stents with proximal opening and 20 stents with distal opening). Group 2 consisted of 42 patients who underwent ESE using a DD in the form of a contracting outer shell. RESULTS: In the 1st group, DD «stumbling¼ in 6 cases (14.6%) required additional tubular hollow rigid conductor. In the 2nd group, there was no need for additional conductor (p=0.011). Intraoperative stent repositioning after its initial installation was required in 7 cases (17.1%) of the 1st group and 16 cases (38.1%) of the 2nd group (p=0.033). Higher likelihood of stent repositioning was observed in distal stent opening. Technical success rate was 100% in both groups. Clinical success rate was 100% in the 1st group and 97.6% in the 2nd group (p>0.05). Incidence of early and long-term postoperative complications was similar (p>0.05). CONCLUSION: ESE with various DDs is safe and effective in patients with malignant unresectable esophageal tumors and symptoms of dysphagia. However, certain features of stent installation should be considered. In our opinion, DD with proximal disclosure is more convenient due to better visual positioning of stent.