Endoscopic treatment of malignant stenosis of the trachea and bronch

Objective. To evaluate the effectiveness of using a self-expanding covered metal stent with additional perforations in patients with tumor stenosis of the trachea and bronchi. Material and methods. In the period from September 2022 to October 2023, 189 patients with respiratory failure were examined, of which 15 patients with detected tumour stenoses of the trachea and bronchi not subject to radical surgery were included in the study. On the basis of the performed analysis the classification of malignant stenoses of trachea and bronchi was developed, where the patients were divided into groups depending on the localisation of the tumour process and the extent of the lesion. Endoscopic treatment included bronchography, labelling and stenting using specially designed stents. The localisation and degree of stenosis were assessed by computed tomography (CT) of the chest organs and bronchoscopy with histological confirmation of the diagnosis. The main efficacy criterion was reduction of dyspnoea according to the mMRC scale. Results. After endoprosthesis, 86.6% of patients had restored respiratory patency, with elimination of respiratory insufficiency and reduction in the degree of dyspnoea. The median survival of patients was more than 12 months, which exceeds the generally accepted prognosis for this group. Conclusion. The proposed method of airway stenting using a specialized stent demonstrates high efficacy in restoring bronchial patency in malignant stenoses of the 1st to 3rd order. The developed classification of stenoses enabled optimization of therapeutic strategy and improvement of treatment outcomes. The proposed treatment algorithm minimized the incidence of complications and led to a significant improvement in patients’ quality of life.