[Sealing esophagobronchial fistulae: better results with self expanding stents than with an esophagobronchial fistula].

OBJECTIVE

To compare the results of plastic endoprostheses and of self expanding stents in patients with an esophagobronchial fistula.

DESIGN

Retrospective, descriptive.

SETTING

Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, the Netherlands.

METHOD: Forty-two patients with an esophagobronchial fistula caused by a malignant tumour in the oesophagus, lungs or mediastinum were fitted with an endoprosthesis during the period 1 January 1991-31 August 1995. Use was made initially of a plastic endoprosthesis with a special tulip funnel (n = 24), later of a coated self expanding stent (n = 18). In seven patients, the fistula had been the first manifestation of the tumour; in 35, a recurrence after earlier treatment was involved. The initial characteristics (sex, age, diagnosis, earlier therapy, signs and symptoms) were the same in both groups.

RESULTS

Dilatation immediately before insertion of a plastic endoprosthesis was necessary in 23 patients (96%); such dilatation was necessary in four of the patients (22%) fitted with a self expanding stent. Complete sealing of the fistula was achieved in 19 (79%) and 15 (83%) patients, respectively. Reoperations were necessary in eight (33%) and three (17%) patients. Early major complications occurred in four (17%) and two (11%) patients.

CONCLUSION

The selfexpanding stent was faster and easier to insert than a plastic endoprosthesis, and effective in sealing an oesophagobronchial fistula.