Original scientific paper

https://doi.org/10.20471/acc.2021.60.04.18

Technical Difficulties and Procedural Complications in Closing Malignant Esophageal-Respiratory Fistulas

Andrei Cozorici ; Gastroenterology Department, Iasi Regional Institute of Oncology, Iasi, Romania
Vlad Porumb ; Grigore T. Popa University of Medicine and Pharmacy; Faculty of Medicine, Surgery Department 2, Iasi Regional Institute of Oncology, Iasi, Romania
Sorinel Lunca ; Grigore T. Popa University of Medicine and Pharmacy; Faculty of Medicine, Surgery Department 2, Iasi Regional Institute of Oncology, Iasi, Romania
Ioana Grigoras ; Iasi University of Medicine and Pharmacy, Faculty of Medicine, Anesthesiology and Intensive Care Department, Iasi Regional Institute of Oncology, Iasi, Romania
Irina Ristescu ; Iasi University of Medicine and Pharmacy, Faculty of Medicine, Anesthesiology and Intensive Care Department, Iasi Regional Institute of Oncology, Iasi, Romania
Iulia Jitaru ; Iasi University of Medicine and Pharmacy, Faculty of Medicine, Anesthesiology and Intensive Care Department, Iasi Regional Institute of Oncology, Iasi, Romania
Emilia Patrascanu ; Iasi University of Medicine and Pharmacy, Faculty of Medicine, Anesthesiology and Intensive Care Department, Iasi Regional Institute of Oncology, Iasi, Romania
Laura Gavril ; Iasi University of Medicine and Pharmacy, Faculty of Medicine, Anesthesiology and Intensive Care Department, Iasi Regional Institute of Oncology, Iasi, Romania
Gabriel Dimofte ; Grigore T. Popa University of Medicine and Pharmacy; Faculty of Medicine, Surgery Department 2, Iasi Regional Institute of Oncology, Iasi, Romania

Abstract

The aim of the study was to outline technical difficulties and procedural complications
of using partially covered esophageal self-expandable metal stents (SEMSs) in malignant esophageal
respiratory fistulas (ERFs) as a palliative treatment option. In this study, 150 patients with malignant
dysphagia underwent treatment with SEMSs. A total of 36 ERFs were detected through endoscopic
or clinical assessment. Complete fistula sealing with SEMSs was possible in 35 of the 36
patients. The majority of fistulas were diagnosed in male patients with advanced esophageal cancer. All
of them presented with prolonged dysphagia and cachexia. Stent migration or tumoral overgrowth
was identified in 6 cases with recurrent dysphagia, and required a second stent insertion. SEMSs were
highly efficient in 98% of the patients studied with ERFs, with successfully sealed ERFs after the first
attempt, with an overall median survival rate of 92 days. The technique of esophageal SEMS placement
is simple and can be rapidly mastered. Patients with ERFs have a respiratory shunt that makes
intubation difficult and is often avoided. Restoring oral feeding increased the patient quality of life.
SEMS placement is generally safe, but has few associated postoperative complications.

Keywords

Esophageal respiratory fistulas (ERFs); Covered self-expandable esophageal metal stents; Stenting complications

Hrčak ID:

275506

URI

https://hrcak.srce.hr/275506

Publication date:

1.12.2021.

Article data in other languages: croatian

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