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Patient of chemo-resistant recurrent carcinoma treated using Y-shaped tracheal stent

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New Delhi | July 25, 2021 5:45:21 PM IST
Doctors recently treated a 51-year-old patient suffering from a recurrent chemo-resistant carcinoma in his trachea by using a Y-shaped tracheal stent. The patient had a few days or weeks to live but stenting prolonged life.

The patient's carcinoma extended to the carina (tracheal bifurcation) and involved the right upper lobe. A team of doctors, led by Dr Vikas Maurya, Director and Head of Department, Pulmonology, Fortis Hospital Shalimar Bagh performed the stenting procedure within a span of 30 minutes, extending the life of the patient.

Previously, the same patient had sought treatment in four different hospitals before presenting to Fortis Hospital Shalimar Bagh. On evaluation, it was determined that he has a recurrent chest infection, shortness of breath, and haemoptysis.

Despite undergoing chemotherapy, the tumour continued to grow, and the lumen (air passage) was getting narrower on account of the same, making it difficult for the patient to breathe. This gave rise to further infection, with blood collecting and oozing from the site.

Talking about the treatment, Dr Vikas Maurya, Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh, said, "The case was complicated as we could not treat the patient with chemotherapy right away as it was a chemo-resistant tumour and had infection as well. Also, patient and family didn't want any general anaesthesia being given in operation theatre due to advanced nature of the disease."

Explaining the procedure, he continued, "So, first we controlled the infection and then we put in a Y-shaped trachea-bronchial stent under conscious sedation, in our bronchoscopy suite, thereby covering the tracheal length, carina and upper portion of both right and left main stem bronchi, which covered the growth and after expanding increased the air passage making it smoother."

"It was a half an hour procedure that was carried out smoothly and through this, we have successfully prolonged the patient's life, he could have otherwise died in few days to weeks due to airway obstruction caused by increasing tracheal cancer growth. The patient is doing fine now, breathing is comfortable, and has been coming to the hospital regularly for regular check-up and is on targeted therapy by Medical Oncologist," concluded Maurya.

Similar to this, in 2012, the Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan retrospectively analyzed the outcomes of airway stenting for esophageal cancer.

Nine patients who underwent airway stenting were reviewed during the study, with all the patients having poor respiratory status due to esophagorespiratory fistula and/or respiratory stenosis.

Researchers had retrospectively assessed the results of airway stenting as five grades of respiratory symptoms, regarding stent-related complications and clinical course and survival.

Another 2010 research by the Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan, which focused on double Y-stent placement for tracheobronchial stenosis, reported 2 cases of malignant disease who underwent double Y-stent placement on the involved carina between the right upper lobe bronchus and the bronchus intermedius as well as on the involved main carina as a unit. The procedure provided successful palliation. (ANI)

 
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