Double stents: airway stenting after esophageal-stent implantation for esophageal cancer.

BACKGROUND/AIMS: Esophageal stenting with self-expandable metallic stents can effectively relieve malignant esophageal strictures in patients in whom chemoradiotherapy has failed. However, airway stenosis can sometimes occur after esophageal stenting. This study aims to evaluate the efficacy of double stents (combined esophageal and airway stents) in patients with recurrent and unresectable esophageal carcinoma in whom definitive chemoradiotherapy has failed.

METHODOLOGY

We retrospectively studied 35 patients who underwent esophageal stenting for recurrent esophageal carcinoma after failure of chemoradiotherapy. These patients were divided into 2 groups; the E group, consisting of patients who underwent esophageal stenting alone and the D group, consisting of patients who required airway stenting after esophageal stenting due to airway compression. Bronchoscopy was performed before esophageal stenting in all patients.

RESULTS

In all 5 patients developed airway stenosis after esophageal stenting. With regard to the bronchoscopic findings before esophageal stenting, the incidence of category-2b findings was significantly higher in the D group than in the E group. Mean survival was 60 days (range 24-102 days).

CONCLUSIONS

Accurate bronchoscopic examination with special attention to compression of the airway should be performed before esophageal stenting in patients in whom the bronchoscopic findings are classified as category 2b or higher.