Double stent for malignant combined esophago-airway lesions.

OBJECTIVE

Combined esophago-airway stenosis and/or esophago-airway fistula due to malignancy bodes a dismal prognosis. We describe our work with double stents for combined esophago-airway lesions.

METHODS

Between February 1994 and July 2000, we treated 11 patients using double stents--the Dumon stent for the airway and the covered Ultraflex for the esophagus. Double stenting was necessitated by combined esophago-airway stenosis in 8 patients and fistulas in 3, of these, 6 had lung cancer and 5 esophageal cancer.

RESULTS

In all but 1 ventilator-dependent patient, dyspnea and dysphagia were significantly reduced and fistula was successfully closed after double stenting. This palliation effectively continued more than 1 month in 5 patients, more than 2 months in 3, and more than 3 months in 2. Mean survival was 64 days (range: 9 to 148 days). Life-threatening complications developed in 5 (45%)--massive bleeding in 3 and uncontrollable esophago-airway fistula in 2. All 5 had received prior radiation.

CONCLUSION

Although patients who received radiation frequently had life-threatening complications after double stenting, this procedure improved the quality of life in patients with esophago-airway stenosis or fistulas due to lung or esophageal cancer.