Y-Stenting Techniques
摘要
Y-shaped stents provide treatment for patients with life-threatening central airway obstruction involving lower trachea, main carina, and proximal mainstem bronchi. Tracheobronchial stenoses may result from malignant as well as from benign disorders. The most frequent cause for malignant central airway obstruction is the extension of adjacent lung cancer. The morbidity due to respiratory distress is significant. Stenting of the airway has been proved to reestablish patency of narrowed central airways. Furthermore, airway stents provide sealing fistulas between trachea or bronchi and esophagus that can be mostly observed in case of esophageal cancer. Stent placement is also a therapeutic option in case of benign diseases like strictures or tracheobronchomalacia; however, surgery remains the gold standard in benign airway stenoses. Generally, Y-stents can be divided into different groups with variable advantages and disadvantages depending mainly on the material they are made from: Y-shaped polymer stents, Y-shaped hybrid stents, and Y-shaped metallic stents. The type of the stent must be carefully selected, considering the biomechanics of the airway obstruction. Although the stents provide immediate relief of symptoms, adverse events like granulation tissue formation, secretion, or mucostasis are common. Therefore, it is important to select the patients prior to airway stenting who will truly benefit from stent implantation.