title: [Sealing of airway fistulas for metallic covered z-type stents].
abstract: BACKGROUND
  Treating airway fistulas, including esophagorespiratory fistulas (ERFs), bronchopleural fistulas (BPFs), and tracheomediastinal fistulas (TMFs), is difficult. The aim of this study is to evaluate the safety and clinical efficacy of metallic covered Z-type stents (CZTS) for the treatment of airway fistulas through bronchoscopy or fluroscopy.
  
  
  METHODS
  Thirty-eight patients with fistulas between the esophagus, mediastina, and airways (32 ERFs, 5 BPFs, and 1 TMF) were retrospectively reviewed after treatment with covered metallic esophageal and airway stents. The fistulas were caused by esophageal (n=26), bronchogenic (n=11), and thyroid (n=1) carcinomas.
  
  
  RESULTS
  Forty-six fistulas were found in 38 patients. The fistula size ranged from 0.5 cm to 7.0 cm. Forty airway covered metal stents (24 Y-type, 8 L-type, and 8 I-type) and 24 esophageal metal stents were placed. Complete responses to the sealing effects of fistulas were noted in 4.3% of all the fistulas, 60.9% showed complete clinical responses, 23.9% showed partial responses, and 10.9% showed no response. An effectivity rate of 89.1% was observed, and the median survival duration of all patients was 5 months.
  
  
  CONCLUSIONS
  The use of CZTS appears to be safe and feasible for the palliative treatment of ERFs, BPFs, and TMFs. Airway stent placement is recommended for patients with ERF. In the event that airway stents fail, esophageal stents should be given. Airway bifurcation stents were observed to be especially suitable for the sealing of fistulas near the trachea carina.
authors.affiliation: Minimal Invasive Tumor Therapy Center, Meitan General Hospital, Beijing 100028, China. wanghongwu2008@yahoo.cn
authors.forename: Hongwu
authors.initials: H
authors.lastname: Wang
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Hang
authors.initials: H
authors.lastname: Zou
authors.forename: Lingfei
authors.initials: L
authors.lastname: Luo
authors.forename: Hongming
authors.initials: H
authors.lastname: Ma
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Zhou
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Sujuan
authors.initials: S
authors.lastname: Liang
mesh_terms: D000368:Aged; D001999:Bronchoscopy / Q000295:instrumentation*; D004937:Esophageal Fistula / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016156:Respiratory Tract Fistula / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents