A fast placement technique for covered tracheobronchial stents in patients with complicated esophagorespiratory fistulas.

PURPOSE: To test an endotracheal placement procedure for malignant esophagorespiratory fistula when endoesophageal placement is inapplicable.

METHODS

We report on patients with malignant esophagorespiratory fistula to which endoesophageal approaches were complicated with a complete obstruction of the hypopharynx, a collapsible tracheobronchus, or a previously placed endoesophageal stents. Gore-Tex membrane-covered Z-stents were deployed in the trachea using a coaxial introducer system in three patients. A Dumon tube was deployed in the bronchus over the bronchofiberscope in one patient.

RESULTS

All fistula were completely sealed by the endotracheal or endobronchial stenting. Symptomatic and clinical improvements were immediate obtained.

CONCLUSION

Endotracheal or endobronchial covered stent placement is thought to be an effective alternative method for sealing esophagorespiratory fistula.