Palliative Management of Malignant Esophago-Tracheobronchial Fistula Using Covered Self-Expandable Metallic Stents: A Single-Center Case Series.

BACKGROUND

Malignant esophago-tracheobronchial fistula (ETBF) is a devastating complication of thoracic malignancies, especially advanced esophageal cancer. Covered self-expandable metallic stents (CSMSs) have emerged as a minimally invasive palliative option.

METHODS

Between May 2015 and June 2021, seven patients with malignant ETBF (five men and two women; mean age 63 ± 5.8 years) underwent CSMS placement at our institution. Primary diseases included five esophageal cancers and two metastatic mediastinal carcinomas. Clinical characteristics, technical success, complications, and outcomes were retrospectively reviewed.

RESULTS

No intraoperative mortality occurred. All patients experienced improvement in dysphagia and/or airway aspiration, allowing resumption of oral intake, which was maintained for a median of 62 days (range, 10-124 days). Median post-stenting survival was 104 days (range, 14-250 days).

CONCLUSION

CSMS placement is a safe and effective palliative treatment for malignant ETBF, preventing aspiration pneumonia and restoring oral intake, thereby supporting home-based care.