Palliative therapy with airway stents for malignant airway stenosis and airway–esophageal fistula: a perioperative analysis for the improvement of life quality

Airway stents have been widely employed for the palliation of malignant airway stenosis (MAS) and airway–esophageal fistula (AEF). The factors that influence the clinical outcomes and peri-stent implantation management should be analyzed. The aim of this study is to analyze the peri-stent prognostic factors related to the survival of patients and emphasize the importance of perioperative management in improving quality of life. The perioperative clinical data were retrospectively reviewed. Univariate and multivariate survival analyses were employed to identify the relationship between perioperative factors and survival. Multiple correspondence analysis was used to illustrate the correlation between the clinical characteristics and progression-free survival time of AEF patients. Twenty-eight patients and 35 patients received airway stents for MAS and AEF, respectively. Technical success and clinical success were achieved in all patients. There was no stent-related death, and the median overall survival (OS) time of the patients with airway stents was 5.2 months. The grade of stenosis (HRIV&V/III: 3.044 [95% CI 1.303, 7.113]; p = 0.006) was regarded as a prognostic factor for MAS patients. Perioperative pneumonia (HR: 2.6 [95% CI 1.08–6.5]; p = 0.034) and perioperative history of acid–base imbalance (HR: 3.4 [95% CI 1.22–9.5]; p = 0.019) were regarded as robust prognostic factors for AEF patients. Airway stenting is an effective palliative treatment to improve the quality of life and prolong survival in patients with advanced stages of malignant MAS or AEF. Clinical medical staff should attach importance to the quality of the safety management of patients after airway stentin.