https://scholars.lib.ntu.edu.tw/handle/123456789/493535
標題: | Are single or dual luminal covered expandable metallic stents suitable for esophageal squamous cell carcinoma with esophago-airway fistula? | 作者: | PEI-MING HUANG JANG-MING LEE |
公開日期: | 2017 | 出版社: | Springer New York LLC | 卷: | 31 | 期: | 3 | 起(迄)頁: | 1148-1155 | 來源出版物: | Surgical Endoscopy | 摘要: | Background: To analyze the outcomes of single or dual luminal self-expandable covered metallic stents (SECMS) for palliative treatment for esophageal cancer with esophago-airway fistula (EAF). Methods: We retrospectively assessed 50 patients who underwent SECMS placement for malignant EAF at our institution between June 2005 and December 2014 to define clinical results of stenting. Treatment provided was classified into initial single airway, single esophageal, or double stent placement. Independent associations between size, location of the EAF, patient’s condition, and the risk of migration or reopening with the different types of stenting were examined using logistic regression analysis. Results: The final management of malignant EAF was esophageal stent in 21 patients, airway stent in 13, and dual stents in 16. No patients failed stenting. During a median follow-up of 178?days (range 1–893?days), the fistula reopened in 33 (66?%) of 50 patients. No factors, including fistula size, location, or initial selection of single or dual stenting, were correlated with reopening. Nineteen (57.6?%) of 33 patients needed restenting, and the reopened EAF was sealed off successfully in 52.6?% of new stent placements. The clinical failure of EAF closure was correlated only with proximal dilated esophagus (p?=?0.013). Mean survival in patients with clinical success of EAF closure was also significantly longer than that in patients with clinical failure (242.0 vs. 80.1?days, p?0.001). KPS (p?=?0.026), cough ability (p?=?0.004), successful closure of EAF (p?=?0.001), and reopening (p?=?0.007) all had significant effects on survival. Conclusions: We conclude that SECMS is safe and effective in the palliation of esophageal cancer with malignant EAF, especially in patients with an otherwise excellent general condition. Other modalities of management are recommended for malignant EAF with proximal dilation of the esophagus. ? 2016, Springer Science+Business Media New York. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84978032354&doi=10.1007%2fs00464-016-5084-6&partnerID=40&md5=da2153c424618a3ef01bee45dc108670 https://scholars.lib.ntu.edu.tw/handle/123456789/493535 |
ISBN: | 27412126 | ISSN: | 0930-2794 | DOI: | 10.1007/s00464-016-5084-6 | SDG/關鍵字: | adult; aged; Article; cancer palliative therapy; clinical article; clinical effectiveness; coughing; esophageal squamous cell carcinoma; esophageal stent; esophagus dilatation; esophagus fistula; female; flexible bronchoscope; follow up; gastroscope; guide wire; human; male; patient safety; priority journal; retrospective study; self expandable metallic stent; stent migration; survival time; tracheobronchial stent; treatment failure; complication; Esophageal Fistula; esophagus tumor; middle aged; palliative therapy; squamous cell carcinoma; very elderly; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Esophageal Fistula; Esophageal Neoplasms; Female; Humans; Male; Middle Aged; Palliative Care; Retrospective Studies; Self Expandable Metallic Stents |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。