title: Placement of transnasal drainage catheter and covered esophageal stent for the treatment of perforated esophageal carcinoma with mediastinal abscess.
abstract: OBJECTIVE
  Perforated esophageal carcinoma with mediastinal abscess is a clinically life-threatening emergency. Herein, we summarize our experience with placement of transnasal drainage catheters and covered esophageal stents for the treatment of this condition.
  
  
  METHODS
  We retrospectively assessed the medical records of 20 patients who were treated using our intervention protocol. Patients received local anesthesia and sedation prior to transnasal drainage catheter placement into the mediastinal abscess, which was followed by esophageal stent placement. Once the fluid was completely drained and the abscess was completely closed, the drainage catheter was removed.
  
  
  RESULTS
  The placement of the drainage catheter and stent was successful in all patients. The drainage catheter was successfully removed from the mediastinum after 7-60 days in 14 patients. During the follow-up of 1-18 months, six patients died from hemorrhage, eight from cancer progression or pulmonary infection, one from atrial fibrillation, and one from asphyxia caused by tracheal compression. The remaining four patients can eat normally.
  
  
  CONCLUSIONS
  Placement of transnasal drainage catheters and covered esophageal stents may be an appropriate palliative therapy for patients with perforated esophageal carcinoma with mediastinal abscess who are not candidates for surgery or have a high postoperative risk. J. Surg. Oncol. 2016;114:725-730. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Xinwei
authors.initials: X
authors.lastname: Han
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, California.
authors.forename: Yan Shi
authors.initials: YS
authors.lastname: Zhao
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Xiangnan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Dechao
authors.initials: D
authors.lastname: Jiao
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Kewei
authors.initials: K
authors.lastname: Ren
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. wuganghenan2004@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
mesh_terms: D000038:Abscess / Q000209:etiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation / Q000379:methods; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D004938:Esophageal Neoplasms / Q000150:complications*; D004939:Esophageal Perforation / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D009666:Nose; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: drainage; esophageal carcinoma; esophageal perforation; mediastinal abscess; stent