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Comparative Study
. 2024 Dec 18;24(1):612.
doi: 10.1186/s12890-024-03434-7.

Silicone stent versus fully covered metallic stent in tracheoesophageal fistula: a single-center retrospective study

Ranran Mo  1 , Jilei Cao  1 , Jinhua Zhou  1 , Cuixia Bian  2
Affiliations
Comparative Study

Silicone stent versus fully covered metallic stent in tracheoesophageal fistula: a single-center retrospective study

Ranran Mo et al. BMC Pulm Med. .

Abstract

Background: In cases of tracheoesophageal fistula (TEF), closure of the fistula by tracheal stent implantation is an effective treatment. In this study, we investigated the efficacy and complications of silicone and metallic tracheal stents for TEF.

Methods: We retrospectively reviewed all patients who underwent tracheal stent insertion for TEF between January 2021 and April 2024 at our institution. Complications were assessed bronchoscopically.

Results: Metallic stents were placed in 21 patients (18 men, 85.7%) and silicone stents in 17 patients (14 men, 82.4%). No differences were observed between the two groups in terms of age, gender, location or size of fistula, primary disease, symptoms or comorbidities. A total of 26 fistulas were found in the metallic stent group, and 19 fistulas were found in the silicone stent group. Stent insertion was successful in all cases. The differences in efficacy and complications after stent placement were not statistically significant between the two groups. Mucus retention was the most frequent complication (P = 0.221), followed by granulation tissue (38.1% with metallic stent and 29.4% with silicone; P = 0.734) and migration (14.3% with metallic stent and 29.4% with silicone; P = 0.426).

Conclusions: Silicone and metallic stents are viable clinical options for treating TEF. Both are equally effective and safe and have acceptable complication rates in TEF.

Keywords: Metallic stent; Silicone stent; Tracheal stent; Tracheoesophageal fistula.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This was a retrospective observational study using anonymous patient data. The protocol has been approved by the Ethics Committee of Jining No.1 People’s Hospital (No.2024-IIT-027). Contact with Prof. Cui-xia Bian, the corresponding author, via e-mail (yzbbc@126.com) is requested should any additional information be needed. All patients agreed and signed informed consent forms before stent deployment. Patients were not contacted or directly impacted by study participation, thus obtaining informed consent was not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A representative metallic Y-shaped stent (No.18) for treatment of a huge tracheoesophageal fistula caused by lung adenocarcinoma. A huge tracheoesophageal fistula involving the trachea, carina, and the middle and upper parts of the left bronchial trachea was observed via bronchoscopy (a, b, c). The maximal diameter of the fistula was approximately 40 mm. A metallic Y-shaped stent was placed to cover the fistula (d, carina; e, position of the left main branch). Following placement of the stent, the lower edge of the stent partially obscured the upper lobe of the left lung, requiring laser fenestration under tracheoscopy (f). A follow-up examination was conducted three days after placement of the stent (g). The patient succumbed to pneumonia 19 days following placement of the stent
Fig. 2
Fig. 2
A representative modified silicone Y-shaped stent (No.3) for treatment of tracheoesophageal fistula caused by esophageal cancer. Two tracheoesophageal fistulas were observed under the computed tomography mediastinal window (a), and a huge tracheoesophageal fistula was observed under bronchoscopy, with a maximum fistula diameter of about 15 mm (b). A Y-shaped silicone stent was placed to cover the fistula (c). One month after placement of the stent, digital radiography showed leakage of the contrast medium, and the stent was modified by suturing a half-turn silicone stent around the periphery of the original stent to increase its diameter and reinserted (d). The patient’s survival after placement of the tracheal stent was 589 days
See this image and copyright information in PMC

References

    1. Kim HS, Khemasuwan D, Diaz-Mendoza J, Mehta AC. Management of tracheo-oesophageal fistula in adults. Eur Respir Rev. 2020;29:200094. - PMC - PubMed
    1. Wang H, Li W, Wang Z, Chen L, Lai G, Jin F, et al. Chinese expert consensus on interventional diagnosis and management of acquired digestive-respiratory tract fistulas (second edition). Clinical Respiratory J. 2023;17:343–56. - PMC - PubMed
    1. Wang H, Zhang N, Li D, Zou H, Zhang J, Luo L, et al. Airway Covered Metallic Stent Based on Different Fistula Location and Size in Malignant Tracheoesophageal Fistula. The American Journal of the Medical Sciences. 2015;350:364–8. - PubMed
    1. Sökücü SN, Özdemir C, Tural Önür S, Dalar L, Altın S. Comparison of silicon and metallic bifurcated stents in patients with malignant airway lesions. Clinical Respiratory J. 2020;14:198–204. - PubMed
    1. Dutau H, Toutblanc B, Lamb C, Seijo L. Use of the Dumon Y-stent in the Management of Malignant Disease Involving the Carina. Chest. 2004;126:951–8. - PubMed

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