Efficacy of the Dumon™ Stent in the Treatment of Airway Gastric Fistula

Ke, Mingyao; Huang, Rui; Lin, Liancheng; Zeng, Junli; Wu, Xuemei

doi:10.4103/0366-6999.213420

Cited by 7 publications

(7 citation statements)

References 4 publications

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“…1,12 Covered metallic stents and silicon stents are most commonly used to treat airway fistula. 1,12,21,22 Metallic stents can adapt well to tortuous airways because of their self-expandable properties; however, they also hold potential disadvantages, such as metal fatigue and membrane damage. 4,21 Silicon stents have the advantage of durability and easy removal; however, their placement depends on rigid bronchoscopy and general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing

Wang¹,

Tao²,

Zhang³

et al. 2019

Ther Adv Respir Dis

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Background: Thoracogastric-airway fistula (TGAF) post-thoracic surgery is a rare and challenging complication for esophagectomy. The aim of this study was to explore the effectiveness of airway stenting for TGAF patients and find related factors coupled with healing of fistula. Methods: This is a retrospective study involving patients with TGAF who were treated with airway stentings. Based on different TGAF locations and sizes on chest computed tomography, covered metallic or silicon airway stents were implanted to cover orifices under interventional bronchoscopy. TGAF healing was defined as the primary outcome, and complete sealing of TGAF as the second outcome. The predictors for TGAF healing were analyzed in univariate and multivariate analysis. Results: A total of 58 TGAF patients were included, of whom 7 received straight covered metallic stents, 5 straight silicon stents, 3 L-shaped covered metallic stents, 21 large Y-shaped covered metallic stents, 17 large Y-shaped silicon stents, and 5 with Y-shaped covered metallic stents. Healing was achieved in 20 (34.5%) patients, and complete sealing in 45 (77.6%) patients. There were no significant differences in healing rate and complete sealing rate between patients receiving metallic stents and those with silicon stents. In univariate analysis, lacking a previous history of radiotherapy or chemotherapy, nonmalignant fistulas, small fistulas, and shorter postesophagectomy duration were found associated with a higher rate of TGAF healing. Only shorter postesophagectomy duration was associated with TGAF healing in multivariate analysis. Conclusions: Both silicon and covered metallic airway stenting are effective methods to close TGAF. A shorter postesophagectomy period may predict better TGAF healing. The reviews of this paper are available via the supplemental material section.

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Section: Discussionmentioning

confidence: 99%

“…The use of the silicon stents in TGAF has been described only in case reports or small single center series. 21 In addition, few studies have made comparisons between covered metallic stents and silicon stents in the same research. Our study showed that both metallic and silicon stents were effective in sealing TGAF in a complete way.…”

Section: Discussionmentioning

confidence: 99%

Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing

Wang¹,

Tao²,

Zhang³

et al. 2019

Ther Adv Respir Dis

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“…[ 15 ] In developed countries, silicone stent was the most commonly used airway stent for benign airway stenosis; however, in China, due to economic and technique reasons, silicone stent insertion (including T tube) was used much less (19/392, 4.8% in this study) and usually was the last choice after other interventional bronchoscopy treatment (such as balloon dilation) failed, or used only for those with obvious dynamic stenosis or airway fistula. [ 16 17 ] Covered retrievable expandable nitinol stent was cheaper in China and easier to be implanted; therefore, it sometimes was used for benign tracheobronchial strictures to instead silicone stent. However, studies examining the use of such stents for benign tracheobronchial strictures have involved only small numbers of patients and short follow-up times.…”

Section: Discussionmentioning

confidence: 99%

Scarring Airway Stenosis in Chinese Adults

Wang

Zhang

Qiu

et al. 2018

Chinese Medical Journal

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Background:Scarring airway stenosis is commonly seen in China as compared to other developed countries, due to the high prevalence of tuberculosis. Nowadays, interventional bronchoscopy treatment has been widely used to treat this disease in China. This study demonstrated the characteristics of scarring airway stenosis in Chinese adults and retrospectively evaluated the efficacy of interventional bronchoscopy treatment of this disease.Methods:Patients with scarring airway stenosis from 18 tertiary hospitals were enrolled between January 2013 and June 2016. The causes, site, and length of scarring airway stenosis were analyzed, and the efficacy of the interventional bronchoscopy treatment was evaluated.Results:The final study cohort consisted of 392 patients. Endotracheobronchial tuberculosis (EBTB) was the most common cause of scarring airway stenosis (305/392, 77.8%) in Chinese adults with a high rate of incidence in young women. The left main bronchus was most susceptible to EBTB, and most posttuberculosis airway scarring stenosis length was 1.1–2.0 cm. The average clinical success rate of interventional bronchoscopy treatment for scarring airway stenosis in Chinese patients is 60.5%. The stent was inserted in 8.7% scarring airway stenosis in China.Conclusions:Scarring airway stenosis exhibits specific characteristics in Chinese patients. Interventional bronchoscopy is a useful and safe treatment method for the disease.

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“…In addition, 16 patients with airway thoracogastric fistula were treated with silicone stents in China: CR was 25%, PR was 56.3%, and NR 18.7. The effect was similar to that of placing a metal stent …”

Section: Individualized Design Of Esophageal Stentsmentioning

confidence: 56%

“…The major complications of metal stents include coughing, sputum retention, incomplete closure of fistula, stent displacement or prolapse, granulation tissue proliferation at both ends of the stent, halitosis, metal fatigue, stent rupture, respiratory tract infection, tracheobronchial perforation, and massive hemorrhage. The major complications related to silicone stents include coughing, migration, obstruction of fistula, formation of granuloma, and pulmonary infection . These complications are generally non‐fatal and can be treated.…”

Section: Stent‐related Complicationsmentioning

confidence: 99%

Chinese expert consensus on diagnosis and management of acquired respiratory‐digestive tract fistulas

Wang

Ke²,

et al. 2018

Thoracic Cancer

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Acquired respiratory‐digestive tract fistulas occur with abnormal communication between the airways and digestive tract, causing the interflow of gas and liquid. Despite advances in surgical methods and the development of multimodal therapy in recent years, patients with acquired respiratory‐digestive tract fistulas continue to exhibit unfavorable clinical outcomes. Therefore, in order to guide clinical practice in China, the Respiratory and Cancer Intervention Alliance of the Beijing Health Promotion Association organized a group of experienced experts in the field to develop this consensus document. Based on a study of clinical application and expert experience in the diagnosis and management of acquired respiratory‐digestive tract fistulas at home and abroad, an Expert Consensus was developed. The panelists recruited comprised experts in pulmonology, oncology, thoracic surgery, interventional radiology, and gastroenterology. PubMed, Chinese Biology Abstract, Chinese Academic Journal, and Wanfang databases were used to identify relevant articles. The guidelines address etiology, classification, pathogenesis, diagnosis and management of acquired respiratory‐digestive tract fistulas. The statements on treatment focus on the indications for different procedures, technical aspects, and preprocedural, post‐procedural and complication management. The proposed guidelines for the diagnosis and management of acquired respiratory‐digestive tract fistulas are the first to be published by Chinese experts. These guidelines provide an in‐depth review of the current evidence and standard of diagnosis and management.

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Efficacy of the Dumon™ Stent in the Treatment of Airway Gastric Fistula

Cited by 7 publications

References 4 publications

Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing

Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing

Scarring Airway Stenosis in Chinese Adults

Chinese expert consensus on diagnosis and management of acquired respiratory‐digestive tract fistulas

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