Double stent for malignant combined esophago-airway lesions.
OBJECTIVE
Combined esophago-airway stenosis and/or esophago-airway fistula due to malignancy bodes a dismal prognosis. We describe our work with double stents for combined esophago-airway lesions.


METHODS
Between February 1994 and July 2000, we treated 11 patients using double stents--the Dumon stent for the airway and the covered Ultraflex for the esophagus. Double stenting was necessitated by combined esophago-airway stenosis in 8 patients and fistulas in 3, of these, 6 had lung cancer and 5 esophageal cancer.


RESULTS
In all but 1 ventilator-dependent patient, dyspnea and dysphagia were significantly reduced and fistula was successfully closed after double stenting. This palliation effectively continued more than 1 month in 5 patients, more than 2 months in 3, and more than 3 months in 2. Mean survival was 64 days (range: 9 to 148 days). Life-threatening complications developed in 5 (45%)--massive bleeding in 3 and uncontrollable esophago-airway fistula in 2. All 5 had received prior radiation.


CONCLUSIONS
Although patients who received radiation frequently had life-threatening complications after double stenting, this procedure improved the quality of life in patients with esophago-airway stenosis or fistulas due to lung or esophageal cancer.
Yamamoto
Ryoji
R
Division of Pulmonary Surgery, Osaka City Medical Hospital, 2-13-22 Miyakojima-Hondori, Miyakojima-ku, Osaka 534-0004, Japan.
Tada
Hirohito
H
Kishi
Akihiro
A
Tojo
Takashi
T
Asada
Hiroki
H
D000368:Aged; D004938:Esophageal Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015607:Stents; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000209:etiology / Q000601:surgery*