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Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing.
- Source :
-
Therapeutic advances in respiratory disease [Ther Adv Respir Dis] 2019 Jan-Dec; Vol. 13, pp. 1753466619871523. - Publication Year :
- 2019
-
Abstract
- Background: Thoracogastric-airway fistula (TGAF) post-thoracic surgery is a rare and challenging complication for esophagectomy. The aim of this study was to explore the effectiveness of airway stenting for TGAF patients and find related factors coupled with healing of fistula.<br />Methods: This is a retrospective study involving patients with TGAF who were treated with airway stentings. Based on different TGAF locations and sizes on chest computed tomography, covered metallic or silicon airway stents were implanted to cover orifices under interventional bronchoscopy. TGAF healing was defined as the primary outcome, and complete sealing of TGAF as the second outcome. The predictors for TGAF healing were analyzed in univariate and multivariate analysis.<br />Results: A total of 58 TGAF patients were included, of whom 7 received straight covered metallic stents, 5 straight silicon stents, 3 L-shaped covered metallic stents, 21 large Y-shaped covered metallic stents, 17 large Y-shaped silicon stents, and 5 with Y-shaped covered metallic stents. Healing was achieved in 20 (34.5%) patients, and complete sealing in 45 (77.6%) patients. There were no significant differences in healing rate and complete sealing rate between patients receiving metallic stents and those with silicon stents. In univariate analysis, lacking a previous history of radiotherapy or chemotherapy, nonmalignant fistulas, small fistulas, and shorter postesophagectomy duration were found associated with a higher rate of TGAF healing. Only shorter postesophagectomy duration was associated with TGAF healing in multivariate analysis.<br />Conclusions: Both silicon and covered metallic airway stenting are effective methods to close TGAF. A shorter postesophagectomy period may predict better TGAF healing. The reviews of this paper are available via the supplemental material section.
- Subjects :
- Adult
Aged
Bronchoscopy adverse effects
Esophageal Neoplasms pathology
Female
Gastric Fistula diagnostic imaging
Gastric Fistula etiology
Humans
Male
Metals
Middle Aged
Prosthesis Design
Respiratory Tract Fistula diagnostic imaging
Respiratory Tract Fistula etiology
Retrospective Studies
Silicones
Time Factors
Treatment Outcome
Wound Healing
Bronchoscopy instrumentation
Esophageal Neoplasms surgery
Esophagectomy adverse effects
Gastric Fistula therapy
Respiratory Tract Fistula therapy
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1753-4666
- Volume :
- 13
- Database :
- MEDLINE
- Journal :
- Therapeutic advances in respiratory disease
- Publication Type :
- Academic Journal
- Accession number :
- 31476949
- Full Text :
- https://doi.org/10.1177/1753466619871523