Esophagorespiratory fistula associated with esophageal cancer: treatment with a Gianturco stent tube

Abstract

A self-expanding silicone-covered tube constructed of Gianturco stents was used for palliative treatment of esophagorespiratory fistula related to esophageal carcinoma in eight patients. All eight were unable to swallow food or water before treatment. The tubes were inserted under fluoroscopic guidance, without technical failure or complication. Clinical improvement was determined by grading food intake capacity on a five-point scale: none, liquid, soft food, most food, or all food. After the procedure, all fistulas were occluded. Four patients could swallow most foods, two could swallow soft food, one could swallow all foods, and one (who died of preexisting pneumonia 10 days after the procedure) could manage only liquids. Three patients were surviving without symptoms of aspiration for 4-24 weeks. Four patients died 6-16 weeks after placement of the stent tubes. Insertion of a silicone-covered stent tube was an effective palliative treatment for esophagorespiratory fistulas caused by esophageal cancer.