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(Chest. 2004;126:951-958.)
© 2004 American College of Chest Physicians

Use of the Dumon Y-stent in the Management of Malignant Disease Involving the Carina*

A Retrospective Review of 86 Patients

Hervé Dutau, MD; Bénédicte Toutblanc, MD; Carla Lamb, MD and Luis Seijo, MD

* From the Thoracic Endoscopy Unit (Drs. Dutau and Toutblanc), Sainte Marguerite Hospital, Marseilles, France; the Interventional Pulmonary Program (Dr. Lamb), Lahey Clinic, Burlington, MA; and the Pulmonary Division (Dr. Seijo), Clínica Universitaria de Navarra, Pamplona, Spain.

Correspondence to: Hervé Dutau, MD, Thoracic Endoscopy Center, Hôpital Sainte Marguerite, 270 Blvd de Sainte Marguerite, 13009 Marseille, France; e-mail: hdutau{at}ap-hm.fr

Objective: To study the efficacy of symptom relief and the safety of the Dumon Y-stent for central airway obstruction in malignant main carinal involvement and in malignant tracheoesophageal fistulas.

Design: A retrospective review.

Setting: Thoracic endoscopy referral center.

Patients and methods: The medical records of 86 patients who had undergone the placement of a Dumon Y-stent at our institution were reviewed and analyzed.

Results: Ninety Dumon Y-stents were placed in 86 patients to relieve symptoms of dyspnea, cough, and/or hemoptysis. Four of these patients required removal of that stent and replacement with a longer Dumon Y-stent due to tumor progression. There were only two instances of procedure-related adverse effects, which included coughing following stent placement lasting 1 week in one patient and stent migration in another patient. In the case of stent migration, the stent required immediate removal, and the patient experienced no adverse consequences. The remaining patients tolerated the stent well, and all experienced subjective symptomatic relief. There were no stent-related deaths. The average duration of a stent after placement was 133 days. The median time of survival following stent insertion was 181 days. Forty-five percent of all patients died at 3 months, and 72% died at 6 months.

Conclusion: The Dumon Y-stent proved to be useful and was well-tolerated in the management of malignant disease involving the main carina. It also provided successful palliation in patients with malignant tracheoesophageal fistulas.

Key Words: airway obstruction • bronchoscopy • esophageal cancer • lung cancer • stents • tracheoesophageal fistula






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