title: Airway Covered Metallic Stent Based on Different Fistula Location and Size in Malignant Tracheoesophageal Fistula.
abstract: BACKGROUND
  Malignant tracheoesophageal fistula (MTEF) is a devastating complication of esophageal cancer, lung cancer or other carcinoma with a shorter life-span and poor life quality. The aim of this study was to assess the effect of airway stent insertion on MTEF patients.
  
  
  METHODS
  A total of 63 MTEF patients were included, 12 patients with lung cancer and 46 patients with esophageal cancers. Eight zones were proposed to classify various fistula locations. Airway stents were selected based on the various zones and fistula size.
  
  
  RESULTS
  Airway stents were successfully inserted in all patients, and both airway and esophageal stents in 8 patients. Most fistula were located in locations II (18/63, 28.6%), III (22/63, 34.9%), then VII (9/63, 14.3%). The stents included 10 (15.9%) I shaped, 8 (12.7%) L shaped and 45 (71.4%) Y shaped. Different stents were placed based on different locations and sizes of fistulas. Overall, mean survival time was 163 days (2-270 days). Most symptoms relieved after stent insertion. Mean Karnofsky score jumped from 43.0 ± 10.7 before stent placement to 66.7 ± 10.8 after stent insertion (P = 0.000). Complete closure was achieved in 45 patients (71.4%), and incomplete closure and leakage were found in 18 patients.
  
  
  CONCLUSIONS
  Airway stent insertion provides an effective approach to improve symptoms and quality of life. The choice of stent based on different fistula location and size may be a reasonable way in clinical practice.
authors.affiliation: Department of Medical Oncology (HW, NZ, DL, HZ, JZ, LL, HM); and the Department of Respiratory Medicine (MT, YZ) Meitan General Hospital, Beijing, China.
authors.forename: Hongwu
authors.initials: H
authors.lastname: Wang
authors.forename: Meimei
authors.initials: M
authors.lastname: Tao
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Dongmei
authors.initials: D
authors.lastname: Li
authors.forename: Hang
authors.initials: H
authors.lastname: Zou
authors.forename: Jieli
authors.initials: J
authors.lastname: Zhang
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
mesh_terms: D058109:Airway Management / Q000379:methods; D001999:Bronchoscopy / Q000379:methods*; D002681:China / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000150:complications*; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007440:Intubation / Q000295:instrumentation / Q000379:methods; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D014132:Trachea / Q000473:pathology / Q000601:surgery; D014138:Tracheoesophageal Fistula / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery