title: Thoracic stomach-right main bronchus fistula treated with dual Y-shaped covered airway stents.
abstract: OBJECTIVE
  To determine the efficacy of dual Y-shaped covered airway stents to treat thoracic stomach-right main bronchus fistulae.
  
  
  METHODS
  Fifteen patients who developed thoracic stomach-right main bronchus fistula after oesophageal cancer resection and postoperative irradiation were retrospectively analysed. All fistulae were close to the right upper lobe bronchus. Two Y-shaped covered airway stents were designed for each patient. Under radiographic guidance, one stent was placed from the right main bronchus into the bifurcation of upper lobe and intermediate bronchus, the other was placed from the trachea into both main bronchi.
  
  
  RESULTS
  All fistulae were closed immediately after stenting. All patients could eat a semi-solid diet. The symptom of coughing while lying down resolved in all patients, and no complications, such as airway bleeding or pneumothorax, occurred. The average survival time was 26.65 months (range 2-40 months, 11 patients were still alive at the study end). Two patients died of tumour recurrence. Another two patients died of pulmonary infections. In one of these patients, there was a long delay between symptom onset and stenting. In the other patient, a small rupture occurred in the silicone membrane covering the stent, which allowed the leakage of gastric contents into the lung.
  
  
  CONCLUSIONS
  Dual Y-shaped covered airway stent placement is feasible and safe to treat thoracic stomach-right main bronchus fistulae. Improvements to the material covering the stents is required.
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Z-M
authors.initials: ZM
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: H-B
authors.initials: HB
authors.lastname: Lu
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: K-W
authors.initials: KW
authors.lastname: Ren
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. Electronic address: hanxinwei2006@163.com.
authors.forename: X-W
authors.initials: XW
authors.lastname: Han
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: G
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
authors.forename: D-C
authors.initials: DC
authors.lastname: Jiao
mesh_terms: D000328:Adult; D000368:Aged; D001983:Bronchial Fistula / Q000601:surgery*; D005260:Female; D005747:Gastric Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome