title: The role of parallel stent insertion in patients with esophagorespiratory fistulas.
abstract: BACKGROUND
  Patients with malignant esophagorespiratory fistulas have a poor prognosis. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. Because insertion of a single stent may be insufficient for palliation, a series of patients who underwent parallel stent insertion were studied.
  
  
  METHODS
  Thirteen patients with esophagorespiratory fistulas who required parallel stents were studied retrospectively. Palliation was evaluated by assessing dyspnea, dysphagia, and coughing associated with eating and/or drinking before and after insertion of stents.
  
  
  METHODS
  Insertion of the first stent (n = 13) resulted in complete relief of symptoms attributed to an esophagorespiratory fistula in 46% and in a reduction in symptoms in 54% of patients. The interval between insertion of the first and second stents ranged from 1 to 182 days (mean 46 days). Insertion of the second stent (n = 12) resulted in complete relief of symptoms in 42% and a reduction in symptoms in 58% of the patients.
  
  
  CONCLUSIONS
  Parallel stent insertion may be indicated in patients with symptoms caused by malignant esophagorespiratory fistula.
authors.affiliation: Department of Medical Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: H J G Desirée
authors.initials: HJ
authors.lastname: van den Bongard
authors.forename: Henk
authors.initials: H
authors.lastname: Boot
authors.forename: Paul
authors.initials: P
authors.lastname: Baas
authors.forename: Babs G
authors.initials: BG
authors.lastname: Taal
mesh_terms: D000328:Adult; D000368:Aged; D001983:Bronchial Fistula / Q000209:etiology / Q000628:therapy*; D001984:Bronchial Neoplasms / Q000150:complications; D004938:Esophageal Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents; D014134:Tracheal Neoplasms / Q000150:complications; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000628:therapy*