Treatment of Esophagorespiratory Fistulas with Silicone-Coated Self-Expanding Metal Stents.
- Author:
Chang Hyeong LEE
1
;
Young Oh KWEON
;
Sung Kook KIM
;
Yong Hwan CHOI
;
Joon Mo CHUNG
Author Information
1. Department of Internal Medicine, College of Medicine, Kyungpook National University, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
Esophagorespiratory fistula;
Silicone-coated self expandable metal stent
- MeSH:
Deglutition Disorders;
Eating;
Fistula*;
Follow-Up Studies;
Hemoptysis;
Humans;
Mortality;
Palliative Care;
Plastics;
Prostheses and Implants;
Silicones;
Stents*;
Water
- From:Korean Journal of Medicine
1998;54(1):24-33
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Implantation of esophageal stents is nowadays considered as the method of choice for the management of esophagorespiratory fistula. However, implantation of conventional plastic prosthesis is inconvenient for the patient and associated with relativelty high mortality and complications. Silicone coated self expandable metal stents have been developed to overcome these limitations of plastic tubes. And then, the efficacy of silicone-coated self expandable metal stents in esophagorespiratory fistulas was investigated. METHODS: Six patients with esophagorespiratory fistulas were treated with silicone-coated self expandable metal stents(Song's esophageal stents). All six patients were unable to swallow food or water before treatment due to aspiration via esophagorespiratory fistula. The stents were inserted under endoscopic and fluoroscopic guidence. Clinical improvement was determined by grading food intake capacity on five-point scale : none, liquid, soft food, solid food, or all food. RESULTS: The stents were successfully inserted in all patients. All stents spontaneously showed sufficient expansion without further endoscopic control. After procedure, all fistulas were sealed and symptoms due to branchial aspiration were disappeared. Dysphagia improved by at least two grades in 5 of the 6 patients(83.3%). One patient died due to massive hemoptysis 11 days after stent placement, which could be regarded as a complication. Retrosternal and epigastric pain were observed in three patients. In the follow-up, tumor overgrowth at the end of the stent was found in one patient, who was retreated with implantation of another stent. CONCLUSION: These results suggest that implantation of silicone-coated self expandable metal stents is a rapid, and effective procedure for the palliative treatment of malignant esophagorespiratory fistulas and other cause of esophagorespiratory fistula.
