Malign havayolu darlıklarında floroskopi eşliğinde trakeal stent yerleştirilmesi

Amaç: Ciddi dispne ile seyreden malign hava yolu darlıklarında sadece floroskopi kullanılarak havayollarına yerleştirilen kendinden açılır metalik stentlerin teknik ve klinik başarısını ortaya koymak. Gereç ve yöntem: Tek merkezde Ocak 2004-Aralık 2012 yılları arasında ciddi, malign trakeal ve bronşiyal darlığı ve buna bağlı ciddi solunum sıkıntısı olup havayollarına metalik stent yerleştirilmiş 12 hasta retrospektif olarak değerlendirildi. İşlemlerin tamamı bronkoskopi olmaksızın sadece floroskopi eşliğinde yapıldı. Klinik başarı pulse oksijen saturasyonu (SpO2) Hugh-Jones sınıflaması ile işlem öncesi ve sonrası karşılaştırılarak değerlendirildi. Teknik başarı işlem sırasında floroskopi ve 48. saatte toraks BT ile değerlendirildi. Bulgular: Tüm hastalar değerlendirildiğinde SpO2 (%) düzeyi işlem öncesi ortalaması 71.3, işlem sonrası 94.5 olarak bulunmuştur. Hugh-Jones sınıflamasına göre artış 1.4± 0.5 (p < 0.05) olarak bulundu. İşlemlerin tamamı teknik ve klinik olarak başarılı olup, major komplikasyon olmadı. Sonuç: Bronkoskopi kullanılmaksızın sadece floroskopi eşliğinde yapılan trakeal stentleme, malign trakeal stenoza bağlı dispneyi gidermede etkin bir yöntemdir.

Floroscopy guided airway stenting at malign airway stenosis

Purpose: To evaluate the technical success and clinical outcome of airway stenting by using self-expandable metallic stents with only fluoroscopy guidance at adult patients having severe dyspnea due to malignant tracheal stenosis. Materials and methods: From January 2004 to December 2012, 12 patients who had fluoroscopy guided airway stenting with metallic stents for severe dyspnea due to malignant tracheal stenosis were retrospectively analysed for technical success and clinical outcome at a single center. All procedures were guided only with fluoroscopy, bronchoscopy was not used for guidance. The pulse oxygen saturation (SpO2 ) and Hugh-Jones classification were used to evaluate the clinical success before and after airway stenting. Technical success was evaluated with fluoroscopy during the procedure and with thorax CT 48 hours after the procedure. Results: The average SpO2 (%) was 71.3 before the procedure and 94.5 after the procedure. Hugh-Jones classification increased 1.4± 0.5 (p< 0.05). All procedures were technically successful and there were no major complications. Conclusion: Floroscopy guided airway stenting without using bronchoscopy is an effective procedure for patients having severe dyspnea due to malignant tracheal stenosis.

Kaynakça

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