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Selected Publication:
Tomaselli, F; Maier, A; Sankin, O; Woltsche, M; Pinter, H; Smolle-Jüttner, FM.
Successful endoscopical sealing of malignant esophageotracheal fistulae by using a covered self-expandable stenting system.
Eur J Cardiothorac Surg. 2001; 20(4):734-738
Doi: 10.1016%2FS1010-7940%2801%2900867-3
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- Co-authors Med Uni Graz
- Maier Alfred
- Pinter Hans
- Sankin Oliver
- Smolle-Juettner Freyja-Maria
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- Abstract:
- OBJECTIVE: Any treatment of tracheo-esophageal fistulae in end-stage malignant stenosis of the esophagus must be weighed against associated morbidity and mortality. In a prospective study we investigated benefits and risks of the use of one type of coated, self-expandable stent. PATIENTS AND METHODS: We treated four male and two female patients, (mean age 68.3 years, range: 38-90 years), with malignant esophago-tracheal fistula non-resectable due to advanced tumour stage and/or functional reasons. All were in a poor general condition suffering from aspiration pneumonia and malnutrition. Four out of the six patients had had one or multiple extra- or endoluminal palliative treatments at a mean interval of 191 days (range: 7 days-15 ms) since the last intervention. The fistulae were sealed by using a covered, self-expandable stent (ULTRAFLEX esophageal stent system, Microinvasive, Boston Scientific Corporation, Boston, MA). RESULTS: Stenting did not cause any technical problems and all fistulae were successfully sealed in a one-step procedure. The median hospital stay was 4.6 days (range: 3-9 days). Except for one late stent induced recurrent fistula treated by re-stenting and tracheostomy, we did not observe any stent associated complications. Five patients died of tumour generalization. The median survival of the patients who died was 78 days (range: 35-129 days). One patient is alive and well at 120 days after stenting. CONCLUSION: In spite of the small number of patients the results suggest that this type of stent represents a safe and efficient approach for palliative endoscopic treatment of this high risk group. Local pretreatment does not preclude the successful use of the self-expandable coated stent.
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- Coated Materials, Biocompatible - therapy
- Esophageal Neoplasms - therapy
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- Find related publications in this database (Keywords)
- esophagotracheal fistulae
- ultraflex scent
- self-expandable stent
- palliation