Currently, there are three methods for tracheal stent placement. The first method is guided by the fiberoptic bronchoscope, and the stent is placed under X-ray fluoroscopy positioning. The second method is to place the stent under the direct view of the rigid bronchoscope under general anesthesia. The third method is to place the stent under the direct view of the fiberoptic bronchoscope.
(1) Indications: Tracheal stent placement can mainly achieve the following purposes:
① It can reconstruct the lumen of the central airway with organic stenosis.
② It can soft trachea and bronchus, and support weak cartilage.
③ It can block trachea and bronchial fistulas or cracks.
The indications for tracheal stent placement are gradually expanding, but it is still mainly used as a palliative treatment. Stent placement for treating tracheal stenosis caused by malignant tumors has been well recognized.
(2) Contraindications: As there are few treatment options available, tracheal stent placement for benign tracheal stenosis is currently considered clinically reasonable. Generally speaking, all benign and malignant tracheal and main bronchial stenosis patients who have lost the opportunity for surgery or are unwilling to receive surgical treatment can be treated with stents. However, the following situations should be treated with caution:
① Pediatric patients. The length and width of the trachea of children are constantly growing and broadening, and the inner diameter and length of the tracheal stent will be shaped once selected, which will not adapt to the growth of the trachea.
② Bleeding tracheostomy.
③ The combination of large airway stenosis leads to small airway stenosis and obstruction, severe pneumothorax, pneumomediastinum and subcutaneous emphysema.
④ Patients with serious damage to their cardiopulmonary function.
⑤ The tumor involves the glottis will cause glottis and subglottic stenosis, and the size of the stent does not match the condition of the lesion.
⑥ Patients with serious infections in the trachea and bronchi.