[Metal endoprostheses for endoscopic therapy in malignant bronchial tumors]

Self-expanding metal stents were implanted in the trachea or main bronchus in 12 patients (eleven men, one woman; mean age 60 +/- 8 years) with nonresectable bronchial carcinoma (n = 11) or tracheal metastasis of a hypernephroma (n = 1). They all had pulmonary complications caused by tumour stenoses (group I: severe dyspnoea [n = 6], group II: retention pneumonia [n = 4] or lung abscess [n = 2] after unsuccessful antibiotic treatment). The procedure was undertaken after local anaesthesia with a flexible bronchoscope (in the first three cases still with a rigid bronchoscope under general anaesthesia) under fluoroscopic control. Immediate reduction in dyspnoea occurred in five of the six patients in group I. In five of the six patients in group II antibiotics cured the infection after stent placement. The therapeutic effect was immediate in severe dyspnoea and retention of secretions. The clinical improvement lasted longer in patients with abscess and retention pneumonia than those with dyspnoea (41 +/- 16 vs. 26 +/- 10 days). If strict indications are observed in cases with malignant bronchial stenosis, implantation of self-expanding stents provides rapidly effective, well-tolerated palliation.