Malignant esophageal stricture and fistula: palliative treatment with polyurethane-covered Gianturco stent.
OBJECTIVE
To evaluate the effectiveness of a polyurethane-covered Gianturco stent in the palliative treatment of malignant esophageal stricture and fistula.


METHODS
Twenty-seven patients with recurrent stricture (n = 24), fistula formation (n = 8), or both (n = 5) underwent palliative treatment for aphagia (n = 15) or dysphagia (n = 12). Eight patients had fistulas to the respiratory tract or mediastinum. A 15-F delivery sheath system was passed through the stricture; the inner dilator was removed, and the stent was compressed into the sheath and advanced with a pusher catheter. Follow-up included chest radiography for 3 days and monthly esophagography or endoscopy.


RESULTS
Covered stents occluded fistulas and opened strictures in 100% of patients. Food intake was upgraded to liquids in 7% of patients, to soft foods in 37% and to regular foods in 56%. New stricture or fistula occurred in 4% and 7% of patients, respectively. Stent migration occurred in 15% of patients. Twenty-one patients died after stent placement, and average life expectancy was 11 weeks.


CONCLUSIONS
A polyurethane-covered Gianturco stent is effective in the palliation of advanced malignant esophageal strictures and fistulas.
Miyayama
S
S
Department of Radiology, Kanazawa University School of Medicine, Japan.
Matsui
O
O
Kadoya
M
M
Yoshikawa
J
J
Gabata
T
T
Kitagawa
K
K
Arai
K
K
Takashima
T
T
D000368:Aged; D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004435:Eating; D004867:Equipment Design; D004937:Esophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005402:Fistula / Q000209:etiology / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000209:etiology / Q000628:therapy; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D010166:Palliative Care; D011140:Polyurethanes; D011859:Radiography; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D013499:Surface Properties; D015996:Survival Rate
D011140:Polyurethanes