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1 From the Department of Chest Diseases and Thoracic Oncology, Hôpital Nord, University Hospital Saint-Etienne, St. Etienne, France
2 From the Department of Physiology, GIP Exercice, Hôpital Nord, University Hospital Saint-Etienne, St. Etienne, France
3 From the Department of Anesthesiology and Intensive Care Unit, Hôpital Nord, University Hospital Saint-Etienne, St. Etienne, France
Stent placement is the only available treatment in patients presenting either a localized external compression or a malacia of the tracheobronchial tree. To assess the functional benefit of prosthesis insertion in these indications, we compared functional respiratory values before, immediately after (48 h), and at sometime after (mean, 10.1 months) operation in 24 patients presenting with a bronchial lesion (B group, n=5) or a lesion of the intrathoracic part (ITT group, n=9) or of the extrathoracic part of the trachea (ETT group, n=10). Before treatment, airflow was severely impaired in most patients without significant differences among the groups. After prosthesis insertion, airflow parameters increased [change in forced expiratory volume in 1 s (
FEV1=440 mL; peak expiratory flow (PEF)=0.92 L·s
1; maximum expiratory flow 25/75 (MEF25/75)=0.47 L · s1; and forced inspiratory volume in 1 s (FIV1=310 mL)] and airway resistances (Raws) decreased ( Raw=0.43 kPa·s1·s1) without any significant variation in either forced vital capacity (FVC) or total lung capacity. Airflow improvement was more apparent in ITT and ETT groups than in the B group. Moreover, inspiratory flow increase and decrease of FEV1/PEF ratio were only observed in the ETT group. This airflow improvement was maintained for a long time after and was associated with a good clinical tolerance. This study supports the clinical and functional benefits of prosthesis placement both in benign and malignant airway compressions for palliative treatment.
Key Words: airflow • palliative treatment • respiratory pulmonary tests • stent • tracheobronchial stenosis
Submitted on January 24, 1994
Accepted on July 1, 2007
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