Airway Complications After Covered Stent Placement for Malignant Esophageal Stricture: Special Reference to Radiation Therapy
| Autor: | Seong Yoon Yi, Ji Yeon Park, Ho-young Song, Ji Hoon Shin, Jin Hyoung Kim |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms Palliative Radiation Therapy medicine.medical_treatment Fistula Esophageal stent medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Survival rate Aged Aged 80 and over business.industry General Medicine Middle Aged Esophageal cancer equipment and supplies medicine.disease Surgery Survival Rate Radiation therapy Treatment Outcome surgical procedures operative Esophageal Stenosis Female Stents Radiology Complication Airway business |
| Zdroj: | American Journal of Roentgenology. 198:453-459 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | OBJECTIVE. The purpose of this study was to evaluate the characteristics of airway complications and survival with special reference to radiation therapy in the care of patients undergoing covered stent placement for malignant esophageal strictures. MATERIALS AND METHODS. A total of 208 patients who underwent stent placement with or without palliative radiation therapy for inoperable esophageal cancer were included. The endpoints were frequency, type, and management of airway complications; association between occurrence of airway complications and radiation therapy history; and differences in stent-to-complication interval and survival period after esophageal stenting between patients who underwent radiation therapy before and those who underwent radiation therapy after stent placement. RESULTS. Airway complications occurred in 23 patients (11.1%): 18 (78.3%) had esophagorespiratory fistula, three (13.0%) had airway narrowing, and two (8.7%) had both com plications. The frequency of airway complications was significantly greater among patients who underwent RT than those who did not (p = 0.005) but was not significantly different be tween the radiation before stenting and radiation after stenting groups (p = 0.158). The median stent-to-complication interval and survival period after esophageal stenting were signifi cantly shorter in the radiation before stenting group than in the radiation after stenting group (p = 0.002, p = 0.001). CONCLUSION. Esophagorespiratory fistula is much more common than airway nar rowing as an airway complication. The rate of complications increases significantly in asso ciation with radiation therapy among patients with malignant esophageal stricture. Clinicians need to be aware of earlier airway complications and poorer prognosis among patients who undergo radiation therapy before placement of an esophageal stent than in patients who undergo radiation after stent placement. |
| Databáze: | OpenAIRE |
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