Clinical benefits and complications of Dumon stent insertion for the treatment of severe central airway stenosis or airway fistula

Mitsuoka, Masahiro; Sakuragi, Tohru; Itoh, Tsuyoshi

doi:10.1007/s11748-007-0131-9

Cited by 39 publications

(29 citation statements)

References 20 publications

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“…Bolliger et al reported migration of the Dumon stent in 3 out of 31 patients who had short (less than 2.5 cm) or conical malignant stenosis [4]. Mitsuoka et al reported Dumon stent migration in 6% and obstruction due to secretions in 9% of 35 patients with benign and malignant airway stenosis [5]. Martinez-Ballarin et al in a group of 64 patients with benign tracheal stenosis treated with Dumon stents also observed migration in 18% and obstruction in 6% of the patients [6].…”

Section: Discussionmentioning

confidence: 99%

Montgomery T-tube placement in the treatment of benign tracheal lesions☆

Carretta

Casiraghi

Melloni

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Montgomery T-tube placement in the treatment of benign tracheal lesions☆

Carretta

Casiraghi

Melloni

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…Nowadays, the most popular stents used in the management of tracheal obstructive lesions are made of silicone. In particular, the Dumon stent (Novatech, Aubagne, France) (Noppen et al 1999) is considered as the most effective airway stent in the market due to its low cost and safety (Dumon et al 1996;Mitsuoka et al 2007). However, the post-operative period faces different possible problems many times such as stent migration or granuloma formation .…”

Section: Introductionmentioning

confidence: 99%

A pre-operative planning for endoprosthetic human tracheal implantation: a decision support system based on robust design of experiments

Trabelsi

Villalobos

Ginel

et al. 2012

Computer Methods in Biomechanics and Biomedical Engineering

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Swallowing depends on physiological variables that have a decisive influence on the swallowing capacity and on the tracheal stress distribution. Prosthetic implantation modifies these values and the overall performance of the trachea. The objective of this work was to develop a decision support system based on experimental, numerical and statistical approaches, with clinical verification, to help the thoracic surgeon in deciding the position and appropriate dimensions of a Dumon prosthesis for a specific patient in an optimal time and with sufficient robustness. A code for mesh adaptation to any tracheal geometry was implemented and used to develop a robust experimental design, based on the Taguchi's method and the analysis of variance. This design was able to establish the main swallowing influencing factors. The equations to fit the stress and the vertical displacement distributions were obtained. The resulting fitted values were compared to those calculated directly by the finite element method (FEM). Finally, a checking and clinical validation of the statistical study were made, by studying two cases of real patients. The vertical displacements and principal stress distribution obtained for the specific tracheal model were in agreement with those calculated by FE simulations with a maximum absolute error of 1.2 mm and 0.17 MPa, respectively. It was concluded that the resulting decision support tool provides a fast, accurate and simple tool for the thoracic surgeon to predict the stress state of the trachea and the reduction in the ability to swallow after implantation. Thus, it will help them in taking decisions during pre-operative planning of tracheal interventions.

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“…The philosophy of its use is creating a support on which the lesion scar can be modeled, and once stabilized the scaring process, it can be taken out. Later, the stents knew an unceasingly evolution, from the simple tube design to the more complex geometries [7,8], and from the static silicone stent to the dynamic or expandable metallic stents [9][10][11], but probably the most popular stent used in the management of tracheal obstructive lesions is the Dumon stent (Novatech; Aubagne, France) [8], which is considered to be the most effective airway stent presently available worldwide based on both cost and safety factors [12]. In 1987, Dumon designed a flexible, studded, silicone prosthesis stent, with no metallic reinforcement to enhance flexibility and facilitate placement and removal.…”

Section: Introductionmentioning

confidence: 99%

“…Facing the clinical interest that causes the implantation of tracheal stents, few studies based on numerical models have been made on prosthesis/airway interaction, generally researches have treated experimental and clinical results of the tracheal stent insertion [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Most of numerical studies have been focused on the development of analytical models simulating an isolated tracheal ring formed by a cartilaginous ring and a muscular membrane [16].…”

Section: Introductionmentioning

confidence: 99%

FE simulation of human trachea swallowing movement before and after the implantation of an endoprothesis

Trabelsi

Palomar

Tobar

et al. 2011

Applied Mathematical Modelling

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a b s t r a c tBackground and aims: Nowadays interventions associated to the implantation of tracheal stents in patients with airway pathologies, are a very common surgery that in the postoperating period can bear many problems such as migration of the stent, development of granulation tissue at the edges of the stent with overgrowth of the tracheal lumen, or accumulation of secretions inside the prosthesis. Among the movements that trachea carries out, swallowing seems to drive harmful consequences for the tracheal tissues surrounding the prosthesis. In this work a finite element model of a human trachea has been developed and used to analyze its behavior during swallowing. Material and methods: In the present work, a complete human trachea finite element model based on experimental study was developed. The real swallowing movement of two patients before and after the implantation of Dumon prosthesis was used to simulate and then analyze the effect that the tracheal implant has on the stress response of the trachea and on the physiological capacity to swallow. Results: In both studied cases with an implanted Dumon prosthesis, patients showed a decrease of their ability to swallow; one lost 26.4% and the other one 18.9% of their tracheal ascending movements. Besides, the prosthesis implantation caused an increase of the stresses located in the superior contact border between the tracheal wall and the prosthesis. It could be seen that the resulting force equivalent to the elevating tracheal muscle forces for degluting, was around F = 13.5 N for the two patients both before and after the stent implantation. Conclusion: The implantation of a Dumon prosthesis modifies the mechanical response of the trachea altering its stress distribution and its ascending movement.

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Clinical benefits and complications of Dumon stent insertion for the treatment of severe central airway stenosis or airway fistula

Abstract: The Dumon stent was found to be effective for treating not only airway stenosis but also airway fistula, with permissible complications. The Dumon stent is therefore considered to be the most effective airway stent presently available worldwide based on both cost and safety factors.

Cited by 39 publications

References 20 publications

Montgomery T-tube placement in the treatment of benign tracheal lesions☆

Montgomery T-tube placement in the treatment of benign tracheal lesions☆

A pre-operative planning for endoprosthetic human tracheal implantation: a decision support system based on robust design of experiments

FE simulation of human trachea swallowing movement before and after the implantation of an endoprothesis

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