Delayed Complications after Placement of Self-Expanding Stents in Malignant Esophageal Obstruction: Treatment Strategies and Survival Rate

Homann, Nils; Noftz, Maria R.; Klingenberg-Noftz, R. D.; Ludwig, D.

doi:10.1007/s10620-007-9862-9

Cited by 85 publications

(63 citation statements)

References 38 publications

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“…1 Esophageal and tracheal stent placement may also induce secondary esophagorespiratory fistula. 4,5 The present case had a history of metastasis in the mediastinal lymph nodes, and a past history of radiation therapy in this area and had undergone esophageal stent placement. These factors are considered to damage esophageal and respiratory tissues and induce esophagorespiratory fistula.…”

Section: Discussionmentioning

confidence: 88%

A case of esophagorespiratory fistula found on videofluorography

Nakagawa¹

2012

Dicle Med J

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ÖZETBu olgu bildirisinde, yemek sırasında tekrarlayan öksür-me ve boğulma nöbetleri olan 59 yaşında bir kadın hasta sunulmuştur. Geçmişinde, mediastinal lenf bezlerinde metastatik tümör bulunması nedeniyle radyasyon ve kemoterapi tedavisi uygulanmış olup, ayrıca özofajiyal stent takılmıştır. Videofluorografide trake ve özofagus arasında özofagorespiratuar fistül olduğu görülmüştür. Bu komplikasyonun prevalansı, mediastinal bölgede malignitesi olan hastaların hayatta kalma sürelerinin uzaması ile artar. Kaplı stent takılması, bu hastaların yaşam kalitesini genelde artırdığından, bu tür fistüller mümkün olduğunca erken teşhis edilmelidir.Anahtar kelimeler: Özofagorespiratuar fistül, videofluorografi, malignite, özofajiyal stent. ABSTRACTWe report a 59-year-old woman who presented with recurrent episodes of coughing and choking while eating. She had a history of metastatic tumor in the mediastinal lymph nodes treated with radiation and chemotherapy. She had also undergone placement of an esophageal stent. Videofluorography demonstrated esophagorespiratory fistula between the trachea and esophagus. The prevalence of this complication increases with prolonged survival of patients with malignancy in the mediastinal region. Such fistulae should be diagnosed as early as possible, because insertion of a covered stent usually improves the quality of life for these patients.

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Section: Discussionmentioning

confidence: 88%

A case of esophagorespiratory fistula found on videofluorography

Nakagawa¹

2012

Dicle Med J

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“…Immediate complications of SEMs such as perforation or bleeding of esophagus are rare [11,19,29]. Early and late complications following the SEMS placement summarized in table 3 and reported between 11.5-43.4% in some studies [1,23,27].…”

Section: Post Procedures Complicationsmentioning

confidence: 99%

“…The stent can be left in esophagus indefinitely for palliation in cases with progressive disease [4]. The median survival of patients with SEMS and re-stenting sometimes was significantly longer (222 ± 26 days) than patients with SEMS and without reintervention [29]. Survival is not related to the location of neoplasm in the esophagus or its histologic type after SEMS insertion [26].…”

Section: Survival After Insertion Of Semsmentioning

confidence: 99%

Palliation of Neoplastic Esophageal Strictures with Metallic Stents

Nozari¹

2017

JCTR

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Abstract:Most patients with advanced esophageal neoplasm have dysphagia and suffer from cachexia and malnourishment.Supportive treatments focus on symptom palliation and improving quality of life at this time. Guidelines illustrated some indications for stent use in esophageal neoplasm such as inoperable neoplastic obstruction, presence of neoplastic fistula or perforation, tumor recurrence and contraindication for chemo-radiotherapy. Palliative stents help relieve dysphagia, manage mouth secretions, reduce aspiration risk, and maintain oral intake. Stent placement sometimes requires both endoscopic and fluoroscopic guidance. A stricture dilation is not necessary before stent placement. Success rate of SEMS placement was reported 80-100%. Complications of stents are bleeding, perforation, migration, and tumor ingrowth. Coated SEMS are the treatment of choice in the presence of neoplastic trachea-esophageal fistula. Partially covered stents are used for neoplastic stricture but their removal is sometimes difficult. The stent can be left in esophagus indefinitely for palliation in cases with progressive disease. In this article, we reviewed the recent literatures for efficacy of palliative metal stents placement in patients with esophageal neoplasm.

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“…Although SEMS are easy to place and the beneficial effects are immediate, recurrent dysphagia has been observed in many patients during a follow-up period of 4-10 weeks (Homann et al, 2008). Radiotherapy, on the other hand, provides long-term relief of dysphagia (Bown, 1991).…”

Section: Stenting and External Beam Radiotherapymentioning

confidence: 99%