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Vol. 16. Issue 3.
Pages 407-418 (May - June 2010)
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Vol. 16. Issue 3.
Pages 407-418 (May - June 2010)
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Eficácia e tolerabilidade de próteses na via aérea
Efficacy and tolerability of airway stents
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Carla Valente1,
Corresponding author
carlavalente77@yahoo.com.br

Serviço de Pneumologia dos Hospitais da Universidade de Coimbra, Av. Bissaya Barreto e Praceta Prof. Mota Pinto, 3000-075 Coimbra.
, Alexandra Catarino2, António Jorge Ferreira2, Carlos Robalo Cordeiro3, Mário Loureiro4
1 Interna Complementar de Pneumologia/Resident, Pulmonology
2 Assistente Hospitalar de Pneumologia/Consultant, Pulmonology
3 Coordenador da Unidade Funcional de Técnicas de Diagnóstico e Terapêutica do Serviço de Pneumologia dos Hospitais da Universidade de Coimbra/Head, Diagnostic and Therapeutic Techniques Unit, Pulmonolgy Service, Hospitais da Universidade de Coimbra
4 Serviço de Pneumologia dos HUC/Pulmonolgy Service, HUC
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Resumo

As próteses na via aérea têm a função de manter as estruturas tubulares abertas e estáveis. A sua colocação está indicada essencialmente na obstrução intrínseca ou compressão extrínseca da via aérea, fístulas ou traqueobroncomalacia.

Com este estudo pretendeu-se determinar a tolerabilidade a eficácia de próteses na via aérea nas situações em que a sua colocação era imprescindível.

Procedeu-se ao estudo retrospectivo dos processos clínicos de 23 doentes em que se tinha procedido à colocação de próteses traqueobrônquicas através de broncoscopia rígida, durante dois anos consecutivos (2006–2007), na Unidade Funcional de Técnicas de Diagnóstico e Terapêutica, tendo sido avaliadas a indi- cação, a eficácia, a tolerabilidade, as complicações e a localização exacta da sua inserção, tendo em conta a informação imagiológica fornecida por TC do tórax. Em todas as situações foram utilizadas próteses flexíveis de silicone tipo Dumon (Tracheobronxane®), sendo previamente avaliada, através de broncoscopia flexível, a necessidade de técnicas complementares, nomeadamente laserterapia e dilatação mecânica.

O estudo efectuado permitiu concluir que a inserção de próteses não apresentou complicações, demonstrando boa tolerabilidade, tendo em conta a maioria das situações, de natureza neoplásica em estádio avançado, apenas com indicação terapêutica paliativa.

Palavras-chave:
Próteses traqueobrônquicas
broncoscopia rígida
Abstract

The function of airway stents is to keep the tubular structures open and stable. Their insertion is essentially indicated for intrinsic obstruction or extrinsic compression of the airway, fistulae or tracheobronchomalacia.

The aim of this study was to determine the tolera bility and efficacy of airway stents in situations in which their insertion was vital. A retrospective study of airway stent insertion with rigid bronchoscopy (23 patients) was carried out over a two year period (2006–2007) at the Diagnostic and Therapeutic Techniques Unit.

We assessed indication, efficacy, tolerability, complications and exact insertion based on chest CT imaging. In all situations Dumon flexible silicon stents (Tracheobronxane ®) were used, with the need for complementary techniques such as laser therapy and mechanical dilation having been previously evaluated by flexible bronchoscopy.

The authors conclude that stent insertion has no complications and good tolerability in the majority of advanced stage oncological situations with indication for palliative management.

Key-words:
Tracheobronchial stent
rigid bronchoscopy
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Bibliografia/Bibliography
[1.]
P.E. Baugnée, C.H. Marquette, P. Ramon, J. Darra, A. Wurtz.
Traitement endoscopique des sténoses trachéales post– intubation.
À propôs de 58 cas. Rev Mal Respir, 12 (1995), pp. 585-592
[2.]
A. Brichet, C. Verkindre, J. Dupont, M.L. Carlier, J. Darras, A. Wurtz, et al.
Multidisciplinary approach to management of postintubation tracheal stenoses.
Eur Resp J, 13 (1999), pp. 888-893
[3.]
Forte V. Ressecção da estenose traqueal pós-intubação com reconstrução da traqueia por anastomose laringotraqueal: análise clínica e cirúrgica, 1996; 206.
[4.]
A.C. Metha, F.Y. Lee, E.M. Cordasco, T. Kirby, I. Eliachar, G. De Boer, Concentric tracheal and subglotic stenosis.
Management using the Nd YAG laser for mucosal sparing followed by gentle dilatation.
Chest, 104 (1993), pp. 673-677
[5.]
M.L. Tedde, S. Nakakubo, R.K. Nakamura, H. Minamoto.
Broncoscopia. terapêutica nas estenoses: dilatações e próteses.
Pneumologia. Atualização e reciclagem,
[6.]
A.L. Rafanan, A.C. Mehta.
Stenting of the tracheobronchial tree.
Radiol Clin North Am, 38 (2000), pp. 395-408
[7.]
J.F. Dumon.
A dedicated tracheobronchial stent.
Chest, 97 (1990), pp. 328-332
[8.]
H. Rousseau, M. Dahan, D. Lauque, P. Carré, A. Didier, I. Bilbao, et al.
Self-expandable prostheses in the tracheobronchial tree.
Radiology, 188 (1993), pp. 199-203
[9.]
J.F. Dumon, S. Cavaliere, J.P. Diaz-Jimenez, J.M. Vergnon, F. Venuta, M.C. Dumon, et al.
Seven-year experience with the Dumon prosthesis.
J Bronchol, 3 (1996), pp. 6-10
[10.]
T. Matsuo, H.G. Colt.
Evidence against routine scheduling of surveillance bronchoscopy after stent insertion.
Chest, 118 (2000), pp. 1455-1459
[11.]
E.Lund Mark, Garland Robert, Ernst Armin.
Airway stenting applications and practice management considerations.
Chest, 131 (2007),
[12.]
S. Cavaliere, J.F. Dumon.
Laser bronchoscopy.
Interventional bronchoscopy, pp. 108-119
[13.]
M. Noppen, M. Meysman, J. D’Haese, et al.
Interventional bronchoscopy: 5-year experience at the Academic Hospital of the Vrije Universiteit Brussel (AZ-VUB).
Acta Clin Belg, 52 (1997), pp. 371-380
[14.]
F. Venuta, E.A. Rendina, T. De Giacomo, et al.
Nd:YAG laser resection of lung cancer invading the airway as a bridge to surgery and palliative treatment.
Ann Thorac Surg, 74 (2002), pp. 995-998
[15.]
C.T. Bolliger, M. Soler, M. Tamm, et al.
Combination endobronchial and conventional therapy possibilities in inoperable central lung tumors.
Schweiz Med Wochenschr, 125 (1995), pp. 1052-1059
[16.]
S. Stohr, C.T. Bolliger.
Stents in the management of malignant airway obstruction.
Monaldi Arch Chest Dis, 54 (1999), pp. 264-268
[17.]
M.M. Mughal, T.R. Gildea, S. Murthy, et al.
Shortterm deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence.
Am J Respir Crit Care Med, 172 (2005), pp. 768-771
[18.]
K.M. Dineen, M.A. Jantz, G.A. Silvestri.
Tracheobronchial stents.
J Bronchol, 9 (2002), pp. 127-137
[19.]
L. Freitag, E. Tekolf, G. Stamatis, et al.
Clinical evaluation of a new bifurcated dynamic airway stent: a 5-year experience with 135 patients.
Thorac Cardiovasc Surg, 45 (1997), pp. 6-12
[20.]
C. Marquette, E. Mensier, M.C. Copin, et al.
Experimental models of tracheobronchial stenoses: a useful tool for evaluating airway stents.
Ann Thorac Surg, 60 (1995), pp. 651-656
[21.]
C.W. Seymour, W.S. Krimsky, J. Sager, et al.
Transbronchial needle injection: a systematic review of a new diagnostic and therapeutic paradigm.
Respiration, 73 (2006), pp. 78-89
[22.]
R.F. Ward, M.M. April.
Mitomycin-C in the treatment of tracheal cicatrix after tracheal reconstruction.
Int J Pediatr Otolrhinolaryngol, 44 (1998), pp. 221-226
[23.]
M.M. Wahidi, H. Felix, A. Ernst.
State of the art interventional pulmonology.
Chest, 131 (2007),
Copyright © 2010. Sociedade Portuguesa de Pneumologia
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