Chest ACCP Career Connection
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Freitag, L.
Right arrow Articles by Stamatis, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Freitag, L.
Right arrow Articles by Stamatis, G.
(Chest. 1996;110:1155-1160.)
© 1996 American College of Chest Physicians

Management of Malignant Esophagotracheal Fistulas With Airway Stenting and Double Stenting

Lutz Freitag MD, FCCP1; Edith Tekolf MD1; Heinz Steveling MD1; Terrence J. Donovan MD1; and Georgios Stamatis MD1

1 From the Ruhrlandklinik, Center for Pulmonary Medicine and Thoracic Surgery, Essen, Germany

Prognosis of inoperable or recurrent esophageal carcinoma is, at best, poor. Once an esophagotracheal fistula has developed, the overall condition of the patient declines rapidly. Aspiration pneumonia and severe coughing are common. The introduction of esophageal tubes does not always seal the fistula sufficiently and may compromise the airway causing stridor and dyspnea. In 30 patients (25 male, 5 female; age 23 to 74 years; mean, 56 years) with very large fistulas and airway problems, we inserted an airway stent (Dynamic) (n=12) or an esophageal tube combined with a Dynamic airway stent (n=18) with the aim of sealing the fistula and restoring patency of the airway and GI passage. The tracheobronchial Dynamic stent was chosen because its slightly concave, flexible posterior silicone membrane adapts ideally to the convex esophageal tube. The stents were well tolerated and significantly improved the quality of life. Of 30 patients, 16 could breathe and swallow unimpaired until shortly before their death. Moderate complaints persisted in five patients, dysphagia in eight patients, and dyspnea in one patient. Mean survival time in the double stent group was significantly greater (110 days) than in the airway stent-only group (24 days) or comparable groups in the literature treated with esophageal tubes only. We conclude that carefully selected patients can benefit from double stenting of esophagus and airways.

Key Words: airway prosthesis • double stenting • Dynamic stent • esophageal cancer • esophageal prosthesis • esophagotracheal fistulas

Submitted on September 1, 1995
Accepted on February 7, 1996




This article has been cited by other articles:


Home page
 ChestHome page
M. Lois and M. Noppen
Bronchopleural Fistulas: An Overview of the Problem With Special Focus on Endoscopic Management
Chest, December 1, 2005; 128(6): 3955 - 3965.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. Ernst, D. Feller-Kopman, H. D. Becker, and A. C. Mehta
Central Airway Obstruction
Am. J. Respir. Crit. Care Med., June 15, 2004; 169(12): 1278 - 1297.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. A. Kvale, M. Simoff, and U. B. S. Prakash
Palliative Care
Chest, January 1, 2003; 123(1_suppl): 284S - 311S.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. P. W. Chan, P. Eng, A. A.L. Hsu, G. M. Huat, and M. Chow
Rigid Bronchoscopy and Stenting for Esophageal Cancer Causing Airway Obstruction*
Chest, September 1, 2002; 122(3): 1069 - 1072.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
L. Kotsis, Z. Papay, and K. Orban
The risk of surgical procedures for the treatment of malignant respiratory fistulas
Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 373 - 373.
[Full Text] [PDF]

Home page
 NEJMHome page
T. H. Baron
Expandable Metal Stents for the Treatment of Cancerous Obstruction of the Gastrointestinal Tract
N. Engl. J. Med., May 31, 2001; 344(22): 1681 - 1687.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
B. Ghaye and R.F. Dondelinger
Imaging guided thoracic interventions
Eur. Respir. J., March 1, 2001; 17(3): 507 - 528.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by the American College of Chest Physicians.