Abstract
Objective
To find an effective treatment for advanced cancer patients with esophageal fistula.
Methods
From 1998 to 2006, we studied 42 patients with advanced esophageal cancer and 5 lung cancer patients with carcinomatous esophageal fistula (3 females, 44 males, aged 29–92 years). Ten patients with both esophageal cancer stricture and fistula were first dilated under endoscope, then a memory stent with a membrane was placed in the esophageal lumen. Others were treated only with a memory stent with a membrane, three of them with a large fistula (diameter >1.5 cm) were treated with bio-protein glue after placement of an esophageal metal stent.
Results
The fistulas were covered by a stent and the patients could eat and drink immediately. Their quality of life was improved and their survival was prolonged, 44 out of 47 patients survived for >3 mo.
Conclusion
Placement of esophageal stent with membrane or in combination with bio-protein glue through endoscope is an effective method for treating the bronchoesophageal fistula.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wright RA, O’Conner KW. A pilot study of endoscopic injection chemo/sclerotherapy of esophageal carcinoma [J]. Gastrointest Endosc 1990; 36:47–48.
Park HS, Do YS, Suh SW, et al. Upper gastrointestinal tract malignant obstruction: initial results of palliation with a flexible covered stent [J]. Radiology 1999; 210:865–870.
Razzaq R, Laasch HU, England R, et al. Expandable metal stents for the palliation of malignant gastroduodenal obstruction [J]. Cardiovasc Intervent Radiol 2001; 24:313–318.
McGrath JP, Browne M, Riordan C, et al. Expandable metal stents in the palliation of malignant dysphagia and oesophageal-respiratory fistulae [J]. Ir Med J 2001; 94:270–272.
Kinsman KJ, DeGregorio BT, Katon RM, et al. Prior radiation and chemotherapy increase the risk of life-threatening complications after insertion of metallic stents for esophagogastric malignancy [J]. Gastrointest Endosc 1996; 43:196–203.
Mason R. Palliation of oesophageal cancer [J]. Surg Oncol 2001;10:123–126.
O’Donnell CA, Fullarton GM, Watt E, et al. Randomized clinical trial comparing self-expanding metallic stents with plastic endoprostheses in the palliation of oesophageal cancer [J]. Br J Surg 2002; 89:985–992.
Cheng YS, Li MH, Chen WX, et al. Comparison of different intervention procedures in benign stricture of gastrointestinal tract [J]. World J Gastroenterol 2004; 10:410–414.
Decker P, Lippler J, Decker D, et al. Use of the polyflex stent in the palliative therapy of esophageal carcinoma: results in 14 cases and review of the literature [J]. Surg Endosc 2001; 15:1444–1447.
Kaneko K, Ito H, Konishi K, et al. Implantation of self-expanding metallic stent for patients with malignant stricture after failure of definitive chemoradiotherapy for T3 or T4 esophageal squamous cell carcinomas [J]. Hepatogastroenterology 2002; 49:699–705.
Lee SH. The role of oesophageal stenting in the non-surgical management of oesophageal strictures [J]. Br J Radiol 2001; 74:891–900.
Cordero JA Jr, Moores DW. Self-expanding esophageal metallic stents in the treatment of esophageal obstruction [J]. Am Surg 2000; 66:956–958.
Dallal HJ, Smith GD, Grieve DC, et al. A randomized trial of thermal ablative therapy versus expandable metal stents in the palliative treatment of patients with esophageal carcinoma [J]. Gastrointest Endosc 2001; 54:549–557.
Acunas B, Poyanli A, Rozanes I. Intervention in gastrointestinal tract: the treatment of esophageal, gastroduodenal and colorectal obstructions with metallic stents [J]. Eur J Radiol 2002; 42:240–248.
Weigel TL, Frumiento C, Gaumintz E. Endoluminal palliation for dysphagia secondary to esophageal carcinoma [J]. Surg Clin North Am 2002; 82:747–761.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhang, Jc., Zhang, Lj., Wu, Q. et al. Palliative endoscopic therapy for cancer patients with esophageal fistula. Chin. J. Cancer Res. 20, 53–56 (2008). https://doi.org/10.1007/s11670-008-0053-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11670-008-0053-9