Double stenting for esophageal and tracheobronchial stenoses.

Abstract

BACKGROUND:

We examined the complications and outcomes of placing stents for both esophageal and tracheobronchial stenoses.

METHODS:

We placed stents for both esophageal and tracheobronchial stenoses in 8 patients (7 with esophageal cancer and 1 with lung cancer). Covered or noncovered metallic stents were used for the esophageal stenoses, except in 1 patient treated with a silicone stent. Silicone stents were used for the tracheobronchial stenoses. The grades of esophageal and tracheobronchial stenoses were scored.

RESULTS:

All patients experienced improvement of grades of both dysphagia and respiratory symptoms after stent therapy. The complications were: (1) 2 patients suffered respiratory distress after placement of the esophageal stent because of compression of the trachea by the stent; and (2) 3 patients developed new esophago-tracheobronchial fistulae, and 2 patients had recurring fistula symptoms because of growth of preexisting fistulae after the stent placement, which were caused by pressure from the 2 stents. Despite the fistulae, the 5 patients treated with covered metallic stents did not complain of fistula symptoms, but 2 patients treated with noncovered metallic or silicone stents did complain.

CONCLUSIONS:

For patients with both esophageal and tracheobronchial stenoses, a stent should be introduced into the tracheobronchus first. Because placement of stents in both the esophagus and tracheobronchus has a high risk of enlargement of the fistula, a covered metallic stent is preferable for esophageal cancer involving the tracheobronchus.

• Authors: H Nomori, H Horio, Y Imazu, K Suemasu
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 70 Issue 6 Pg. 1803-7 (Dec 2000) ISSN: 0003-4975 [Print] Netherlands
• PMID: 11156075 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Coated Materials, Biocompatible
• Metals
• Silicones

Topics

• Adult
• Aged
• Airway Obstruction (etiology, therapy)
• Bronchial Diseases (etiology, therapy)
• Coated Materials, Biocompatible
• Deglutition Disorders (etiology, therapy)
• Esophageal Neoplasms (therapy)
• Esophageal Stenosis (etiology, therapy)
• Female
• Follow-Up Studies
• Humans
• Male
• Metals
• Middle Aged
• Palliative Care
• Silicones
• Stents
• Tracheal Stenosis (etiology, therapy)
• Tracheoesophageal Fistula (etiology)
• Treatment Outcome