Thorac Cardiovasc Surg 2007; 55(3): 196-198
DOI: 10.1055/s-2006-924629
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Esophageal Stent Placement for the Palliation of Dysphagia in Lung Cancer

Y. Yoruk1
  • 1Department of Thoracic Surgery, Trakya University Medical Faculty, Edirne, Turkey
Further Information

Publication History

received May 21, 2006

Publication Date:
05 April 2007 (online)

Abstract

Background: The aim of this study was to evaluate the experience with expandable metal stents for the palliation of malignant dysphagia caused by lung cancer. Methods: Between August 2002 and April 2006, we deployed esophageal metal stents in 14 patients with esophageal involvement from lung cancer. The mean age of the patients was 61.4 years, and 12 were male patients. Expandable metal stents were inserted under fluoroscopic control over a guide-wire with the patient under conscious sedation. Results: Four patients had concomitant tracheoesophageal fistula. Eleven patients had received previous chemotherapy or radiotherapy and two had had a pneumonectomy. Immediate improvement after esophageal stent replacement was seen in all patients. The fistula was sealed off in all. All the patients remained asymptomatic during follow-up. All patients died, with mean survival of 10 weeks for patients with fistula and 8.3 months in the patients without fistula. Conclusion: The poor quality of life associated with malignant dysphagia and tracheoesophageal fistula in lung cancer patients can be significantly improved by a non-surgical intervention such as the deployment of expandable metal stents.

References

  • 1 Camidge D R. The causes of dysphagia in carcinoma of the lung.  J R Soc Med. 2001;  94 567-572
  • 2 Hyde L, Hyde C. Clinical manifestations of lung cancer.  Chest. 1974;  65 299-306
  • 3 Martini N, Goodner J T, D'Angio G J, Beattie E J. Tracheoesophageal fistula due to cancer.  J Thorac Cardiovasc Surg. 1970;  59 319-324
  • 4 Stankey R M, Roshe J, Sogocio R M. Carcinoma of the lung and dysphagia.  Dis Chest. 1969;  55 13-17
  • 5 Christie N A, Buenaventura P O, Fernando H C, Nguyen N T, Weigel T L, Ferson P F, Luketich J D. Results of expandable metal stents for malignant esophageal obstruction in 100 patients: short-term and long-term follow-up.  Ann Thorac Surg. 2001;  71 1797-1802
  • 6 Moores D WO, Ilves R. Treatment of esophageal obstruction with covered, self-expanding esophageal wallstents.  Ann Thorac Surg. 1996;  62 963-967
  • 7 Shin J H, Song H Y, Ko G Y, Lim J O, Yoon H K, Sung K B. Esophagorespiratory fistula: long-term results of palliative treatment with covered expandable metallic stents in 61 patients.  Radiology. 2004;  232 252-259
  • 8 Raijman I, Siddique I, Ajani J, Lynch P. Palliation of malignant dysphagia and fistulae with coated expandable metal stents: experience with 101 patients.  Gastrointest Endosc. 1998;  48 172-179
  • 9 Bethge N, Sommer A, Vakil N. Palliation of malignant esophageal obstruction due to intrinsic and extrinsic lesions with expandable metal stents.  Am J Gastroenterol. 1998;  93 1829-1832
  • 10 Reed C E. Pitfalls and complications of esophageal prosthesis, laser therapy, and dilatation.  Chest Surg Clin North Am. 1997;  7 623-636
  • 11 Farivar A S, Vallieres E, Kowdley K V, Wood D E, Mulligan M S. Airway obstruction complicating esophageal stent placement in two post-pneumonectomy patients.  Ann Thorac Surg. 2004;  78 22-23
  • 12 Nomori H N, Horio H, Imazu Y, Suemasu K. Double stenting for esophageal and tracheobronchial stenosis.  Ann Thorac Surg. 2000;  70 1803-1807

Prof. Yener Yoruk

Trakya University Medical Faculty
Department of Thoracic Surgery

Trakya Tip Fakultesi Gogus Cerrahisi AD

22030 Edirne

Turkey

Phone: + 90 28 42 35 59 36

Fax: + 90 28 42 35 59 36

Email: yyoruk@trakya.edu.tr