Thoracic stomach–right main bronchus fistula treated with dual Y-shaped covered airway stents

Aim To determine the efficacy of dual Y-shaped covered airway stents to treat thoracic stomach–right main bronchus fistulae. Material and methods Fifteen patients who developed thoracic stomach–right main bronchus fistula after oesophageal cancer resection and postoperative irradiation were retrospe...

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Bibliographic Details
Published in:Clinical radiology 2017-06, Vol.72 (6), p.517.e1-517.e6
Main Authors: Li, Z.-M, Lu, H.-B, Ren, K.-W, Han, X.-W, Wu, G, Jiao, D.-C
Format: Article
Language:English
Subjects:
Adult
Aged
Bronchial Fistula - surgery
Female
Gastric Fistula - surgery
Humans
Male
Middle Aged
Prosthesis Design
Radiology
Retrospective Studies
Stents
Treatment Outcome
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Summary:Aim To determine the efficacy of dual Y-shaped covered airway stents to treat thoracic stomach–right main bronchus fistulae. Material and methods Fifteen patients who developed thoracic stomach–right main bronchus fistula after oesophageal cancer resection and postoperative irradiation were retrospectively analysed. All fistulae were close to the right upper lobe bronchus. Two Y-shaped covered airway stents were designed for each patient. Under radiographic guidance, one stent was placed from the right main bronchus into the bifurcation of upper lobe and intermediate bronchus, the other was placed from the trachea into both main bronchi. Results All fistulae were closed immediately after stenting. All patients could eat a semi-solid diet. The symptom of coughing while lying down resolved in all patients, and no complications, such as airway bleeding or pneumothorax, occurred. The average survival time was 26.65 months (range 2–40 months, 11 patients were still alive at the study end). Two patients died of tumour recurrence. Another two patients died of pulmonary infections. In one of these patients, there was a long delay between symptom onset and stenting. In the other patient, a small rupture occurred in the silicone membrane covering the stent, which allowed the leakage of gastric contents into the lung. Conclusion Dual Y-shaped covered airway stent placement is feasible and safe to treat thoracic stomach–right main bronchus fistulae. Improvements to the material covering the stents is required.
ISSN:0009-9260
1365-229X
DOI:10.1016/j.crad.2016.12.008