Y-Stent Surgery - Department of Pulmonary Medicine

Central airway obstruction is any condition which causes obstruction of the trachea (windpipe) and major airways. It can result from many causes including tumors, tracheal stenosis, trauma including accidents, and chemical exposure. The most common causes of central airway obstruction are lung cancer, and tracheal stenosis most commonly occurring as a result of increased endotracheal tube cuff pressures. Patients generally present with dyspnea (shortness of breath) and stridor (wheezing). The condition is also difficult to diagnose with many patients being misdiagnosed as asthma and receiving treatment for asthma. General treatment options include tracheal dilation using rigid bronchoscope, laser surgery and tracheal reconstruction.  

Tracheal surgery used to be the major treatment in the past. The narrowed or diseased part of the trachea would be cut off and the cut ends of the trachea sewn together with sutures. However, tracheal surgery is associated with numerous complications. Also, in many cases, surgery is not possible because narrowing of the airways prevents administration of general anesthesia. In such cases, the alternatives are to perform tracheal surgery under cardiopulmonary bypass, which is associated with even more complications. Laser surgery is not routinely available because of excess costs.

The Department of Pulmonary Medicine added another feather to its cap when the interventional pulmonology team of the department along with a team of anesthetists placed a silicone Y-stent in the trachea (wind pipe), first time ever in the country. The silicone Y-stent was placed in trachea in a patient who had lower tracheal tumor which had completely blocked the airway. It was a life threatening condition as narrowing of the trachea led to severe difficulty in breathing and respiratory failure. The interventional pulmonology team along with the anesthetists removed the endotracheal growth through a rigid bronchoscope, dilated the airways by means of rigid bronchoscope and dilating balloons, and placed a Y-stent to maintain the patency of the lumen.  

The interventional pulmonology team has also placed stents in other cases of central airway obstruction. The stents are also placed for the indication of tracheoesophageal fistula, which is communication between the food pipe and wind pipe with resultant dire circumstances. The interventional pulmonology team of the department was elated as this was a major achievement.

Interventional pulmonology team

Dr Dheeraj Gupta -- 9914209823

Dr Ritesh Agarwal - 9914209825

Anesthesia team

Dr V Arya - 9914209531

Dr Narayana - 9914209522

Dr Hemant - 9914209529

Dr Sameer - 9914208491

Dr Bhupesh - 9914209511

No of cases - 1-2/month 

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