title: Double stenting of oesophagus and airways in palliative treatment of patients with oesophageal cancer is efficient but associated with a high morbidity.
abstract: BACKGROUND
  Double stenting of oesophagus and airways may be required in palliative treatment of patients with locally advanced oesophageal cancer.
  
  
  OBJECTIVE
  To assess feasibility, efficacy and complications occurring in patients with locally advanced oesophageal cancer receiving both oesophagus and airways stenting.
  
  
  METHODS
  In one single centre between 1997 and 2005, among 180 patients with locally advanced oesophageal cancer treated by the palliative placement of a self-expanding metal stent, patients requiring double stenting of oesophagus and airways were identified. Clinical efficacy, complications and survival were retrospectively collected.
  
  
  RESULTS
  Fifteen patients (8.3% of 180) required a double stenting at follow-up. Symptomatic efficacy of oesophagus and airways stenting was 86.7% for dysphagia and 100% for dyspnoea. Median survival after the second stent insertion was 99 days. Life-threatening early complications occurred in three patients after double stenting (20%), including two deaths following oesophageal perforation and massive haemoptysis, respectively. Procedure-related mortality was 13.3%.
  
  
  CONCLUSIONS
  Double stenting of oesophagus and airways is feasible in patients with locally advanced oesophageal cancer, with a relevant clinical efficacy. However, early major complications including procedure-related death may occur in as many as 20% of patients. This treatment should be reserved to very selected patients with severe symptoms and end-stage disease.
authors.affiliation: Department of Hepato-Gastroenterology and Nutrition, Rouen University Hospital & ADEN-EA3234/IFRMP23, Institute for Biomedical Research, Rouen, France. stephanelecleire@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Lecleire
authors.forename: M
authors.initials: M
authors.lastname: Antonietti
authors.forename: F
authors.initials: F
authors.lastname: Di Fiore
authors.forename: E
authors.initials: E
authors.lastname: Ben-Soussan
authors.forename: S
authors.initials: S
authors.lastname: Bota
authors.forename: M-F
authors.initials: MF
authors.lastname: Hellot
authors.forename: L
authors.initials: L
authors.lastname: Thiberville
authors.forename: P
authors.initials: P
authors.lastname: Michel
authors.forename: E
authors.initials: E
authors.lastname: Lerebours
authors.forename: P
authors.initials: P
authors.lastname: Ducrotté
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000188:drug therapy* / Q000517:prevention & control; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D015607:Stents / Q000009:adverse effects* / Q000592:standards; D015996:Survival Rate; D016896:Treatment Outcome