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Usefulness of esophageal stenting by using a covered self-expandable metallic stent for esophagorespiratory fistula associated with esophageal carcinoma
Authors:Umehara Seiji  Fujiwara Hitoshi  Shiozaki Atushi  Komatsu Shuhei  Ichikawa Daisuke  Okamoto Kazuma  Murayama Yasutoshi  Kuriu Yoshiaki  Ikoma Hisashi  Nakanishi Masayoshi  Ochiai Toshiya  Kokuba Yukihito  Sonoyama Teruhisa  Otsuji Eigo
Institution:Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
Abstract:We report three cases of esophagorespiratory fistula associated with esophageal carcinoma successfully treated with esophageal stenting by using a covered self-expandable metallic stent (SEMS). All three cases had advanced esophageal carcinoma at middle thoracic esophagus with esophagorespiratory fistula at the level of esophageal carcinoma. Case 1 is a 58-year-old man who had lung abscess due to esophagopulmonary fistula caused after induction chemoradiotherapy. He underwent a surgical resection of the affected lung and intraoperative esophageal stenting with dietary intake starting on day 26 after stenting. Case 2 is a 60-year-old man with esophagopulmonary fistula caused after primary chemotherapy. He started to take an oral intake on day 3 after esophageal stenting. Case 3 is a 68-year-old man with esophagobronchial fistula detected at the first medical examination. He started to take an oral diet on day 7 after esophageal stenting. All three cases had a rapid improvement of respiratory symptoms, pneumonia and malnutrition by esophageal stenting leading to marked improvement of impaired general condition. Esophageal stenting is a useful method for palliation of esophageal carcinoma with respiratory fistula.
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