Endoscopic palliative intubation of the esophagus invaded by lung cancer.
Thirty-two patients with esophageal involvement by lung cancer were managed by endoscopic intubation. In 22 patients with extrinsic esophageal strictures, the success rate of intubation was 91%, and 82% were discharged with their dysphagia relieved and esophageal patency restored. The mean survival rate was 4.4 months. In 10 patients with esophago-bronchial fistulas, 3 had the fistulous tract obliterated and lived a mean of 5 months. This low success rate of closing fistulas is due to failure to seal off the space between the stent and the fistula because of absence of tumor-associated stenosis. The overall morbidity rate was 28.1% (18.8% perforation, 6.3% hemorrhage, and 3.1% tracheal obstruction). The overall mortality rate was 18.8%. Although complications were more frequent than in primary esophageal tumors, endoscopic intubation was the only way to palliate this desperate condition and provided 66.6% of patients with relief of symptoms, nutritional improvement, and a mean survival time of 4.5 months.
Department of Gastroenterology, Hôpital Universitaire, Erasme, ULB, Brussels, Belgium.
M
M
Buset
B
B
Des Marez
M
M
Cremer
D001983:Bronchial Fistula / Q000209:etiology / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications*; D004937:Esophageal Fistula / Q000209:etiology / Q000628:therapy*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods*; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*