Malignant esophageal fistulas and perforations: management with plastic-covered metallic endoprostheses
| Autor: | Robert Morgan, J. Ellul, A. Adam, R. C. Mason, E. R. E. Denton, M. Glynos |
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| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms Fistula medicine.medical_treatment Polyurethanes Perforation (oil well) Esophageal Fistula medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Esophagus Aged Esophageal Perforation business.industry Esophageal disease Palliative Care Stent Equipment Design medicine.disease Dysphagia Surgery Radiography medicine.anatomical_structure Metals Case-Control Studies Carcinoma Squamous Cell Female Stents Radiology Polyethylenes medicine.symptom business |
| Zdroj: | Radiology. 204:527-532 |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | To evaluate prospectively the efficacy of plastic-covered metallic endoprostheses in patients with malignant esophageal fistulas and perforations.Thirty-nine patients with incurable esophageal carcinoma who developed esophagorespiratory fistulas (n = 20) or perforations (n = 19) were treated with plastic-covered metallic stents.Covered Wallstent endoprostheses were placed in 36 patients and covered Gianturco stents in three. All 19 perforations and 18 of 20 fistulas were successfully closed (clinical success rate, 95%). Symptoms of aspiration or dysphagia improved in all successfully treated patients. Mean survival was 81.8 days (range, 1-370 days). One patient with a closed perforation developed a fistula 16 weeks later and was treated with a second, overlapping stent; three patients with recurrent fistulas were treated with additional esophageal stents (one patient) or tracheal stents (two patients). In four patients, stent migration (two Gianturco and two Wallstent endoprostheses) necessitated placement of an additional stent.Covered metallic stents offer effective treatment for perforations and fistulas in patients with esophageal malignancy. Patients with recurrent fistulas can be treated with additional stents. Fistulas close to the upper esophageal sphincter may be closed with placement of parallel covered metallic stents in the esophagus and trachea. |
| Databáze: | OpenAIRE |
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