World Association for Bronchology and Interventional Pulmonology (WABIP) guidelines on airway stenting for malignant central airway obstruction.
airway stenting
complications
malignant central airway obstruction
mechanical ventilation
mortality
quality of life
surveillance
Journal
Respirology (Carlton, Vic.)
ISSN: 1440-1843
Titre abrégé: Respirology
Pays: Australia
ID NLM: 9616368
Informations de publication
Date de publication:
29 May 2024
29 May 2024
Historique:
received:
30
01
2024
accepted:
16
05
2024
medline:
30
5
2024
pubmed:
30
5
2024
entrez:
30
5
2024
Statut:
aheadofprint
Résumé
Malignant Central Airway Obstruction (MCAO) encompasses significant and symptomatic narrowing of the central airways that can occur due to primary lung cancer or metastatic disease. Therapeutic bronchoscopy is associated with high technical success and symptomatic relief and includes a wide range of airway interventions including airway stents. Published literature suggests that stenting practices vary significantly across the world primarily due to lack of guidance. This document aims to address this knowledge gap by addressing relevant questions related to airway stenting in MCAO. An international group of 17 experts from 17 institutions across 11 countries with experience in using airway stenting for MCAO was convened as part of this guideline statement through the World Association for Bronchology and Interventional Pulmonology (WABIP). We performed a literature and internet search for reports addressing six clinically relevant questions. This guideline statement, consisting of recommendations addressing these six PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with expert experience when necessary. Panel members participated in the development of the final recommendations using the modified Delphi technique.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.
Références
Daneshvar C, Falconer WE, Ahmed M, Sibly A, Hindle M, Nicholson TW, et al. Prevalence and outcome of central airway obstruction in patients with lung cancer. BMJ Open Respir Res. 2019;6(1):e000429.
Ost DE, Ernst A, Grosu HB, Lei X, Diaz‐Mendoza J, Slade M, et al. Therapeutic bronchoscopy for malignant central airway obstruction: success rates and impact on dyspnea and quality of life. Chest. 2015 May;147(5):1282–1298.
Cavaliere S, Venuta F, Foccoli P, Toninelli C, La Face B. Endoscopic treatment of malignant airway obstructions in 2,008 patients. Chest. 1996 Dec;110(6):1536–1542.
Chen CH, Wu BR, Cheng WC, Chen CY, Chen WC, Hsia TC, et al. Interventional pulmonology for patients with central airway obstruction: An 8‐year institutional experience. Medicine. 2017 Jan;96(2):e5612.
Ernst A, Feller‐Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med. 2004 Jun 15;169(12):1278–1297.
Dutau H, Dumon JF. Airway stenting revisited: 30 years, the age of reason? J Bronchology Interv Pulmonol. 2017 Oct;24(4):257–259.
Brouns M, Jayaraju ST, Lacor C, De Mey J, Noppen M, Vincken W, et al. Tracheal stenosis: a flow dynamics study. J Appl Physiol. 2007). Mar;102(3):1178–1184.
Mathew R, Hibare K, Dalar L, Roy WE. Tracheobronchial stent sizing and deployment practices airway stenting practices around the world: a survey study. J Thorac Dis. 2020 Oct;12(10):5495–5504.
Guyatt GH, Oxman AD, Kunz R, Falck‐Ytter Y, Vist GE, Liberati A, et al. Going from evidence to recommendations. BMJ. 2008 May 10;336(7652):1049–1051.
Percivalle E, Genini E, Chiesa A, Gerna G. Comparison of a new light diagnostics and the CMV brite to an in‐house developed human cytomegalovirus antigenemia assay. J Clin Virol. 2008 Sep;43(1):13–17.
Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995 Aug 5;311(7001):376–380.
Djulbegovic B, Guyatt G. Evidence vs consensus in clinical practice guidelines. JAMA. 2019 Aug 27;322(8):725–726.
Marchese R, Poidomani G, Palumbo VD, Lo Nigro C, Caterino U, Lo Monte AI, et al. Secondary Carina and Lobar bronchi stenting in patients with advanced lung cancer: is it worth the effort? A clinical experience. Ann Thorac Cardiovasc Surg. 2020 Dec 20;26(6):320–326.
Holden VK, Ospina‐Delgado D, Chee A, Parikh MS, Carreiro MM, Alape Moya D, et al. Safety and efficacy of the tracheobronchial bonastent: a single‐center case series. Respiration. 2020;99(4):353–359.
Tanigawa N, Kariya S, Komemushi A, Nakatani M, Yagi R, Sawada S. Metallic stent placement for malignant airway stenosis. Minim Invasive Ther Allied Technol. 2012 Mar;21(2):108–112.
Niu JM, Zhang J, Qiu XJ, Wang J, Pei YH, Wang YL, et al. Comparison of clinical features and stent placement outcomes between airway stenosis caused by primary pulmonary malignancies and that caused by primary non‐pulmonary malignancies. Chin Med J (Engl). 2019 Feb;132(4):431–436.
Mitsuoka M, Sakuragi T, Itoh T. Clinical benefits and complications of Dumon stent insertion for the treatment of severe central airway stenosis or airway fistula. Gen Thorac Cardiovasc Surg. 2007 Jul;55(7):275–280.
Dutau H, Toutblanc B, Lamb C, Seijo L. Use of the Dumon Y‐stent in the management of malignant disease involving the carina: a retrospective review of 86 patients. Chest. 2004 Sep;126(3):951–958.
Miyazawa T, Miyazu Y, Iwamoto Y, Ishida A, Kanoh K, Sumiyoshi H, et al. Stenting at the flow‐limiting segment in tracheobronchial stenosis due to lung cancer. Am J Respir Crit Care Med. 2004 May 15;169(10):1096–1102.
Stephens KE, Wood DE. Bronchoscopic management of central airway obstruction. J Thorac Cardiovasc Surg. 2000 Feb;119(2):289–296.
Dutau H, Di Palma F, Thibout Y, Febvre M, Cellerin L, Naudin F, et al. Impact of silicone stent placement in symptomatic airway obstruction due to non‐small cell lung cancer—a French Multicenter Randomized Controlled Study: the SPOC Trial. Respiration. 2020;99(4):344–352.
Lee EYC, McWilliams AM, Salamonsen MR. Therapeutic rigid bronchoscopy intervention for malignant central airway obstruction improves performance status to allow systemic treatment. J Bronchology Interv Pulmonol. 2022 Apr 1;29(2):93–98.
Catarata MJP, Saleiro S, Araújo VS. Outcomes of airway stents in the palliative care of patients with cancer. Am J Hosp Palliat Care. 2021 Jan;38(1):19–24.
Razi SS, Lebovics RS, Schwartz G, Sancheti M, Belsley S, Connery CP, et al. Timely airway stenting improves survival in patients with malignant central airway obstruction. Ann Thorac Surg. 2010 Oct;90(4):1088–1093.
Miyazawa T, Arita K. Airway stenting in Japan. Respirology. 1998 Dec;3(4):229–234.
Wang T, Zhang J, Qiu XJ, Wang J, Pei YH, Niu JM. Customized self‐expanding bare metal Y stents in the treatment of malignant carinal stenosis: a retrospective analysis. Ann Palliat Med. 2021 Apr;10(4):4184–4192.
Tjahjono R, Chin RYK, Flynn P. Tracheobronchial stents in palliative care: a case series and literature review. BMJ Support Palliat Care. 2018 Sep;8(3):335–339.
Akram MJ, Khalid U, Abu Bakar M, Ashraf MB, Butt FM, Khan F. Indications and clinical outcomes of fully covered self‐expandable metallic tracheobronchial stents in patients with malignant airway diseases. Expert Rev Respir Med. 2020 Nov;14(11):1173–1181.
Oki M, Saka H. Airway stenting for patients with airway stenosis because of small cell lung cancer. Clin Respir J. 2018 Jul;12(7):2257–2263.
Nagano H, Kishaba T, Nei Y, Yamashiro S, Takara H. Indications of airway stenting for severe central airway obstruction due to advanced cancer. PLoS One. 2017;12(6):e0179795.
Mroz RM, Kordecki K, Kozlowski MD, Baniukiewicz A, Lewszuk A, Bondyra Z, et al. Severe respiratory distress caused by central airway obstruction treated with self‐expandable metallic stents. J Physiol Pharmacol. 2008 Dec;59(Suppl 6):491–497.
Oki M, Saka H. Temporary use of silicone stents for severe airway stenosis in untreated malignant lymphoma. J Bronchol Interv Pulmonol. 2013 Jan;20(1):21–27.
Oviatt PL, Stather DR, Michaud G, Maceachern P, Tremblay A. Exercise capacity, lung function, and quality of life after interventional bronchoscopy. J Thorac Oncol. 2011 Jan;6(1):38–42.
Miyazawa T, Yamakido M, Ikeda S, Furukawa K, Takiguchi Y, Tada H, et al. Implantation of ultraflex nitinol stents in malignant tracheobronchial stenoses. Chest. 2000 Oct;118(4):959–965.
Abdullah V, Yim AP, Wormald PJ, van Hasselt CA. Dumon silicone stents in obstructive tracheobronchial lesions: the Hong Kong experience. Otolaryngol Head Neck Surg. 1998 Feb;118(2):256–260.
Yim AP, Abdullah V, Izzat MB, van Hasselt CA. Video‐assisted interventional bronchoscopy. The Hong Kong Experience. Surg Endosc. 1998 May;12(5):444–447.
Wang Y, Xu J, Wu Q, Zhou Y, An Z, Lv W, et al. Clinical comparison of airway stent placement in intervention room and operating room. Zhongguo Fei Ai Za Zhi. 2020 Jun 20;23(6):451–459.
Furukawa K, Ishida J, Yamaguchi G, Usuda J, Tsutsui H, Saito M, et al. The role of airway stent placement in the management of tracheobronchial stenosis caused by inoperable advanced lung cancer. Surg Today. 2010 Apr;40(4):315–320.
Mahmood K, Wahidi MM, Thomas S, Argento AC, Ninan NA, Smathers EC, et al. Therapeutic bronchoscopy improves spirometry, quality of life, and survival in central airway obstruction. Respiration. 2015;89(5):404–413.
Ma G, Yang R, Gu B, Wang D, Liao W, He X. Tracheal stent placement provides opportunity for subsequent anti‐cancer therapy for cancer patients with malignant respiratory complications. Ann Palliat Med. 2021 Feb;10(2):1042–1049.
Oki M, Saka H, Hori K. Airway stenting in patients requiring intubation due to malignant airway stenosis: a 10‐year experience. J Thorac Dis. 2017 Sep;9(9):3154–3160.
Song JU, Park HY, Kim H, Jeon K, Um SW, Koh WJ, et al. Prognostic factors for bronchoscopic intervention in advanced lung or esophageal cancer patients with malignant airway obstruction. Ann Thorac Med. 2013 Apr;8(2):86–92.
Bolliger CT, Probst R, Tschopp K, Solèr M, Perruchoud AP. Silicone stents in the management of inoperable tracheobronchial stenoses. Indications and limitations. Chest. 1993 Dec;104(6):1653–1659.
Iyoda A, Azuma Y, Sano A, Sakai T, Koezuka S, Otsuka H, et al. Contributions of airway stent for long‐term outcome in patients with malignant central airway stenosis or obstruction. J Bronchol Interv Pulmonol. 2021 Jul 1;28(3):228–234.
Lachkar S, Couraud S, Salaün M, Roger M, Bota S, Guisier F, et al. Self‐expanding metallic Y‐stent compared to silicone Y‐stent for malignant lesions of the main carina: a single center retrospective study. Respir Med Res. 2020 Nov;78:100767.
Sökücü SN, Özdemir C, Tural Önür S, Dalar L, Altın S. Comparison of silicon and metallic bifurcated stents in patients with malignant airway lesions. Clin Respir J. 2020 Mar;14(3):198–204.
Verma A, Goh SK, Tai DYH, Kor AC, Abisheganaden J, Sein ZNN, et al. Outcome differences between recanalized malignant central airway obstruction from endoluminal disease versus extrinsic compression. Lasers Med Sci. 2019 Jul;34(5):955–962.
Okiror L, Jiang L, Oswald N, Bille A, Rajesh P, Bishay E, et al. Bronchoscopic management of patients with symptomatic airway stenosis and prognostic factors for survival. Ann Thorac Surg. 2015 May;99(5):1725–1730.
Saji H, Furukawa K, Tsutsui H, Tsuboi M, Ichinose S, Usuda J, et al. Outcomes of airway stenting for advanced lung cancer with central airway obstruction. Interact Cardiovasc Thorac Surg. 2010 Oct;11(4):425–428.
Chhajed PN, Somandin S, Baty F, Mehta AJ, Azzola A, Leuppi J, et al. Therapeutic bronchoscopy for malignant airway stenoses: choice of modality and survival. J Cancer Res Ther. 2010;6(2):204–209.
Breitenbücher A, Chhajed PN, Brutsche MH, Mordasini C, Schilter D, Tamm M. Long‐term follow‐up and survival after Ultraflex stent insertion in the management of complex malignant airway stenoses. Respiration. 2008;75(4):443–449.
Tsutsui H, Kubota M, Yamada M, Suzuki A, Usuda J, Shibuya H, et al. Airway stenting for the treatment of laryngotracheal stenosis secondary to thyroid cancer. Respirology. 2008 Sep;13(5):632–638.
Lemaire A, Burfeind WR, Toloza E, Balderson S, Petersen RP, Harpole DH, et al. Outcomes of tracheobronchial stents in patients with malignant airway disease. Ann Thorac Surg. 2005 Aug;80(2):434–437. discussion 437–438.
Murgu S, Langer S, Colt H. Bronchoscopic intervention obviates the need for continued mechanical ventilation in patients with airway obstruction and respiratory failure from inoperable non‐small‐cell lung cancer. Respiration. 2012;84(1):55–61.
Lin SM, Lin TY, Chou CL, Chen HC, Liu CY, Wang CH, et al. Metallic stent and flexible bronchoscopy without fluoroscopy for acute respiratory failure. Eur Respir J. 2008 May;31(5):1019–1023.
Ishida A, Oki M, Saka H. Fully covered self‐expandable metallic stents for malignant airway disorders. Respir Investig. 2019 Jan;57(1):49–53.
Gaafar AH, Shaaban AY, Elhadidi MS. The use of metallic expandable tracheal stents in the management of inoperable malignant tracheal obstruction. Eur Arch Otorhinolaryngol. 2012 Jan;269(1):247–253.
Matsuda N, Matsumoto S, Nishimura T, Wakamatsu H, Kunihiro M, Sakabe T. Perioperative management for placement of tracheobronchial stents. J Anesth. 2006;20(2):113–117.
Chan KPW, Eng P, Hsu AAL, Huat GM, Chow M. Rigid bronchoscopy and stenting for esophageal cancer causing airway obstruction. Chest. 2002 Sep;122(3):1069–1072.
Ortiz‐Comino RM, Morales A, López‐Lisbona R, Cubero N, Diez‐Ferrer M, Tebé C, et al. Silicone stent versus fully covered metallic stent in malignant central airway stenosis. Ann Thorac Surg. 2021 Jan;111(1):283–289.
Lee HJ, Labaki W, Yu DH, Salwen B, Gilbert C, Schneider ALC, et al. Airway stent complications: the role of follow‐up bronchoscopy as a surveillance method. J Thorac Dis. 2017 Nov;9(11):4651–4659.
Matsuo T, Colt HG. Evidence against routine scheduling of surveillance bronchoscopy after stent insertion. Chest. 2000 Nov;118(5):1455–1459.
Marchese R, Poidomani G, Paglino G, Crimi C, Lo Nigro C, Argano V. Fully covered self‐expandable metal stent in tracheobronchial disorders: clinical experience. Respiration. 2015;89(1):49–56.
Chung FT, Chen HC, Chou CL, Yu CT, Kuo CH, Kuo HP, et al. An outcome analysis of self‐expandable metallic stents in central airway obstruction: a cohort study. J Cardiothorac Surg. 2011 Apr 8;6:46.
Lecourtois B, Jankowski A, Arbib F, Lantuejoul S, Brichon PY, Moro‐Sibilot D, et al. Endobronchial tumours in a campaign for early detection of bronchial cancer: computed tomography versus endoscopy. Diagn Interv Imaging. 2012 Jul;93(7–8):604–611.
Breen DP, Dutau H. On‐site customization of silicone stents: towards optimal palliation of complex airway conditions. Respiration. 2009;77(4):447–453.
Sonett JR, Keenan RJ, Ferson PF, Griffith BP, Landreneau RJ. Endobronchial management of benign, malignant, and lung transplantation airway stenoses. Ann Thorac Surg. 1995 Jun;59(6):1417–1422.
Routila J, Herhi E, Korpi J, Pulkkinen J, Koivunen P, Rekola J. Tracheobronchial stents in patients with malignant airway disease: Finnish tertiary care experience. Interact Cardiovasc Thorac Surg. 2021 Oct 4;33(4):557–563.
Makkar P, Revelo A, Lee R, Chawla M. A single center experience of feasibility of a novel self‐expanding metallic airway stent (Bonastent): a case series. J Bronchol Interv Pulmonol. 2019 Oct;26(4):254–259.
Madan K, Dhooria S, Sehgal IS, Mohan A, Mehta R, Pattabhiraman V, et al. A multicenter experience with the placement of self‐expanding metallic tracheobronchial Y stents. J Bronchol Interv Pulmonol. 2016 Jan;23(1):29–38.
McGrath EE, Warriner D, Anderson P. The insertion of self expanding metal stents with flexible bronchoscopy under sedation for malignant tracheobronchial stenosis: a single‐center retrospective analysis. Arch Bronconeumol. 2012 Feb;48(2):43–48.
Aktaş Z, Öztürk A, Yılmaz A, Kızılgöz D, Yurtseven G. Complications of silicone Y stents placed due to malignant airway stenosis. Tuberk Toraks. 2019 Mar;67(1):22–30.
Schulze AB, Evers G, Tenk FS, Schliemann C, Schmidt LH, Görlich D, et al. Central airway obstruction treatment with self‐expanding covered Y‐carina nitinol stents: a single center retrospective analysis. Thorac Cancer. 2022 Apr;13(7):1040–1049.
Li Y, Zhu M, Chen J, Ren K, Wan L, Lu H, et al. Single Y‐shaped tracheal self‐expandable metallic stent for emergent carinal stenosis combined with stenosis of the right main and intermediate bronchi. Medicine (Baltimore). 2020 May 29;99(22):e20498.
Gompelmann D, Eberhardt R, Schuhmann M, Heussel CP, Herth FJF. Self‐expanding Y stents in the treatment of central airway stenosis: a retrospective analysis. Ther Adv Respir Dis. 2013 Oct;7(5):255–263.
Grosu HB, Eapen GA, Morice RC, Jimenez CA, Casal RF, Almeida FA, et al. Stents are associated with increased risk of respiratory infections in patients undergoing airway interventions for malignant airways disease. Chest. 2013 Aug;144(2):441–449.
Ost DE, Shah AM, Lei X, Godoy MCB, Jimenez CA, Eapen GA, et al. Respiratory infections increase the risk of granulation tissue formation following airway stenting in patients with malignant airway obstruction. Chest. 2012 Jun;141(6):1473–1481.
Husain SA, Finch D, Ahmed M, Morgan A, Hetzel MR. Long‐term follow‐up of ultraflex metallic stents in benign and malignant central airway obstruction. Ann Thorac Surg. 2007 Apr;83(4):1251–1256.
Mallow C, Thiboutot J, Semaan R, Hayes MM, Hales R, Ram A, et al. External beam radiation therapy combined with airway stenting leads to better survival in patients with malignant airway obstruction. Respirology. 2018 Mar 12;23:860–865.
Miyazaki T, Yamasaki N, Tsuchiya T, Matsumoto K, Takagi K, Nagayasu T. Airway stent insertion simulated with a three‐dimensional printed airway model. Ann Thorac Surg. 2015 Jan;99(1):e21–e23.
Guibert N, Didier A, Moreno B, Mhanna L, Brouchet L, Plat G, et al. Treatment of post‐transplant complex airway stenosis with a three‐dimensional, computer‐assisted customized airway stent. Am J Respir Crit Care Med. 2017 Apr 1;195(7):e31–e33.
Guibert N, Didier A, Moreno B, Lepage B, Leyx P, Plat G, et al. Treatment of complex airway stenoses using patient‐specific 3D‐engineered stents: a proof‐of‐concept study. Thorax. 2019 Aug;74(8):810–813.
Gildea TR, Young BP, Machuzak MS. Application of 3D printing for patient‐specific silicone stents: 1‐year follow‐up on 2 patients. Respiration. 2018;96(5):488–494.
Shan Q, Huang W, Shang M, Wang Z, Xia N, Xue Q, et al. Customization of stent design for treating malignant airway stenosis with the aid of three‐dimensional printing. Quant Imaging Med Surg. 2021 Apr;11(4):1437–1446.
Lischke R, Pozniak J, Vondrys D, Elliott MJ. Novel biodegradable stents in the treatment of bronchial stenosis after lung transplantation. Eur J Cardiothorac Surg. 2011 Sep;40(3):619–624.
Chao YK, Liu KS, Wang YC, Huang YL, Liu SJ. Biodegradable cisplatin‐eluting tracheal stent for malignant airway obstruction: in vivo and in vitro studies. Chest. 2013 Jul;144(1):193–199.
Gilabert‐Porres J, Martí S, Calatayud L, Ramos V, Rosell A, Borrós S. Design of a nanostructured active surface against gram‐positive and gram‐negative bacteria through plasma activation and in situ silver reduction. ACS Appl Mater Interfaces. 2016 Jan 13;8(1):64–73.