Abstract
Background: Patients with advanced esophageal cancer often present with airway obstruction symptoms requiring emergency intervention. At the Vietnam National Cancer Hospital (VNCH), silicone stents, typically inserted via rigid bronchoscopy, were instead effectively placed through tracheostomy, yielding positive outcomes.
Methods: From June 2019 to December 2023, 40 esophageal cancer patients with dyspnea due to tracheal blockage received airway silicone stenting by tracheostomy at the ENT Department at the VNCH.
Results: The mean age was 57.4± 9.0 years, ranging from 36 to 79 years. All patients were male (100%). Most patients had a 2-6 cm narrowing segment (87.5%). Most patients had airway stenosis due to compression (77.5%). Approximately one-third of all patients had grade I, II, or III airway stenosis, according to the Cotton-Myers classification. Intraoperatively, only 3 patients experienced hemorrhage (7.5%), which was controlled well by using bipolar coagulation forceps. Noneof the patients had serious complications, such as pneumomediastinum, actelasia, or acute respiratory failure. The only complication that occurred was mucus plugging inthe stent (30%), which was quickly resolved by draining through the tracheostomy. Most patients (92.5%) had SpO2 lower than 95% before surgery. After the procedure, all the patients had a normal SpO2 (SpO2 ≥ 95%).
Conclusion: Silicone stenting through tracheostomy in respiratory distress patients is safe, cost-effective, and valuable for the management of airway involvement in esophageal cancer patients. Our approach could be a good option for other centers to apply, especially in countries with healthcare resource constraints.