2023 World Conference on Lung Cancer (Posters)-EP09.01. Reverse Endobronchial Y-stent Implantation in Selected Cases of the Malignant Central Airway Obtruction

EP09.01. Reverse Endobronchial Y-stent Implantation in Selected Cases of the Malignant Central Airway Obtruction - PDF(Slides)

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The study examined the use of reverse endobronchial Y-stent implantation in selected cases of central airway neoplasm obstruction. The best method to secure airway patency in patients with advanced cancer and critical airway obstruction is implantation of a Y-stent. In cases where the right upper lobe bronchi are additionally occluded, it is possible and recommended to implant the Y-stent in a reverse manner, with the longer left bronchial arm implanted into the right main bronchi.<br /><br />The study involved a retrospective analysis of self-expanding, coated Y-stent implantation procedures performed at the Department of Thoracic Surgery, Pomeranian Medical University, Szczecin, Poland. The study included patients treated between November 2021 and November 2022 with a tumor of the right lung causing narrowing of the central airways and closure of the upper lobe bronchi.<br /><br />During the study period, 8 successful reverse Y-stent implantations were performed in patients with obstruction of the distal trachea and proximal segments of the main bronchi, along with occlusion of the upper lobe bronchi. The majority of patients had lung cancer, and one patient had esophageal cancer. The Y-stents used had dimensions suitable for tracheal and bronchial arms, and the longer left bronchial arm was implanted into the right main bronchi. The reverse Y-stent implantation resulted in rapid clinical improvement, primarily a reduction in shortness of breath.<br /><br />The study concludes that in certain cases, reverse Y-stent implantation can provide better stabilization of narrowed airways in neoplastic disease. It highlights the non-standard use of Y-stents adapted to endobronchial conditions altered by cancer. This technique enables restoration of airway patency without adverse effects and improves the stability of the main bronchi, preventing recurrence of obstruction through hypertrophic changes in the right upper lobe bronchi. The successful outcome of reverse Y-stent implantation allows for further treatment such as radiotherapy and chemotherapy.

Asset Subtitle

Jaroslaw Pieróg

Meta Tag

Speaker Jaroslaw Pieróg

Topic Metastatic NSCLC: Local Therapies - Effects

Keywords

reverse endobronchial Y-stent implantation

central airway neoplasm obstruction

airway patency

Y-stent

right upper lobe bronchi

retrospective analysis

self-expanding coated Y-stent

Department of Thoracic Surgery

lung cancer

esophageal cancer