Silicone Y-Stent Placement on the Secondary Left Carina

Abstract

Background: The silicone Y-stent has mainly been used for the treatment of lesions around the main carina, and only a few case reports have been published on the technique for the lesions around the secondary left carina (LC2). Objectives: We investigated the feasibility, efficacy and safety of a stenting technique using a silicone Y-stent for patients with airway stenosis around LC2. Methods: Patients who underwent airway stent placement between December 2010 and September 2014 in a single center were retrospectively reviewed. Under general anesthesia, using rigid and flexible bronchoscopes, the airway lumen was re-established followed by Y-stent placement on LC2. Results: We performed 274 airway stenting procedures for 253 patients during the study period. Twelve of them (7 with lung cancer, 3 with esophageal cancer/carcinosarcoma, 1 with thyroid cancer and 1 with renal cancer) underwent a Y-stent placement on LC2. Respiratory symptoms were relieved in all patients. Six of 7 patients with supplemental oxygen, including the mechanically ventilated patient before stent placement, could be discharged without supplemental oxygen. The chest radiograph after the procedure showed increased lung volume in all 7 patients with partial or complete atelectasis. Median survival after stenting was 197 days at the time of data collection. Retention of secretions occurred in 1 and hemoptysis in another patient. Conclusions: Silicone Y-stent placement on LC2 is technically feasible, effective and acceptably safe.

Placement of tracheobronchial silicone Y-stents: Multicenter experience and systematic review of the literature

“…[101213141516171819] The most common indication for deploying silicone Y-stent was tracheobronchial obstruction and TEF due to malignancy. [10171820] Postintubation tracheal stenosis, airway malacia, and others were the benign disorders that necessitated stent placement [Table 2]. [121315] Malignancy (285, 84.3%) was the most common underlying disease that caused CAO and/or TEF.…”

Airway stenting in patients requiring intubation due to malignant airway stenosis: a 10-year experience

“…At our institution, we performed all stenting procedures using both rigid and flexible bronchoscopes under general anesthesia in the operating room. For airway stenosis, stenting was performed using a silicone straight stent (DUMON; Novatech, La Ciotat, France), silicone bifurcated stent (DUMON or OKI; Novatech), or self-expandable metal stent (Ultraflex, covered type; Boston Scientific, Natick, MA, USA) after bronchoscopic airway reestablishment using argon plasma coagulation, electrocautery, a CryoProbe, a highpressure balloon, or the bevel of a rigid bronchoscope as previously described (10)(11)(12). After the stent insertion, acetylcysteine nebulization was performed three times daily.…”

Creation of a Balloon-Expandable Bifurcated Covered Stent to Treat a Complex Left Anastomotic Stricture in a Lung Transplant Recipient

“…If a stent is needed on the left side, a straight stent may not be effective, and bifurcated silicone Y-stents with limbs going into the LUL and LLL have been used by our institution and others [5][6][7]. Upper lobe departure holes can be created in silicone stents, but for anatomical reasons, that strategy is usually more useful on the right than the left [8].…”