J Korean Radiol Soc.
1995 Jun;32(6):901-907.
Treatment of Esophagorespiratory Fistulas Associated with Esophageal Carcinoma: Effectiveness and Problems of a Modified Gianturco Stent
Abstract
- PURPOSE
To evaluate the effectiveness and problems of Gianturco stent for treatment of esophagorespiratory fistulas caused by esophageal carcinoma.
MATERIALS AND METHODS
In a 6~year period, we have treated 95 patients of esophageal carcinomas with silicone-covered modified Gianturco stent. Among those patients, ten had an esophagorespiratory fistula. We retrospectively analyzed the effect of stent for the occlusion of esophagorespiratory fistula, food intake capacity of patients, clinical and procedural problems of the stent. RESULT: After procedure, all fistulas were occluded successfully. Of the 10 patients, two could swallow all kinds of food, four most of foods, three soft foods, and one only liquid foods. In one patient, the fistula was reopened probably resulting from the reflux due to the presence of another lesion in the distal esophagus at 1 week after procedure. Two patients complained of dyspnea due to tracheal compression by the proximal tip of the stent and tracheal invasion of tumor after 4 and 11 weeks. In one patient, fistula was recurred due to tumor overgrowth on proximal and distal portion after 24 weeks. The fistulas recurred from the tumor overgrowth or reflux were sucessfully treated with another esophageal stent. The tracheal compression by the proximal tip of the stent and invasion by esophageal cancer was treated with tracheal stent and radiation therapy.
CONCLUSION
Insertion of silicone-covered modified Gianturco stent was an effective method for the palliative treatment of esophagorespiratory fistula caused by esophageal cancer. Simultaneous use of tracheal stent is also recommended in patients with tracheal compression by the proximal tip of the stent and invasion by esophageal cancer.
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