esophageal ca airway stent

Esophageal cancer is the most common cause of extrapulmonary malignant central airway obstruction (MCAO). MCAO is usually managed by a multidisciplinary approach involving tumor debulking, stent placement, and palliative radiotherapy. MCAO is a challenge in itself; here, it becomes even more challenging as it was accompanied by grade 3 oral submucous fibrosis, nasal synechiae, and multiple enlarged cervical nodes causing excessive compression of the trachea along with acute hypercapnic respiratory failure. Herein, a 65-year-old woman with multiple challenges, where death was imminent, managed with a collaborative approach involving awake nasal intubation in the sitting position and placement of a stent via a flexible bronchoscope, as rigid bronchoscopy was not possible in view of limited mouth opening...

BACKGROUND: The treatment of malignant stenosis involving the carina or bronchi is challenging due to complicated anatomy with individual variation, which makes it necessary to customize stents for each patient. Therefore, this study aims to evaluate the feasibility of a novel metallic segmented airway stent customized with the aid of three-dimensional (3D) printing for such cases. METHODS: The stents were individually customized with the aid of a 3D printed mold based on computed tomography (CT) images according to the anatomical features of the airway...

BACKGROUND: Although an airway stent is used for malignant central airway stenosis or obstruction, long-term outcomes are unknown. In this study, we retrospectively analyzed the clinical features of patients who required stenting for malignant central airway stenosis or obstruction. PATIENTS AND METHODS: We retrospectively analyzed clinical data from 116 patients with stenting for central airway stenosis or obstruction who underwent treatment at Toho University Hospital from 1998 to 2018...

BACKGROUND: Self-expandable metallic stent (SEMS) placement is an urgent procedure for patients with malignant central airway stenoses (CASs) and central airway fistulas (CAFs). The aim of this study was to determine the outcome and survival after SEMS placement in patients with malignant CASs and CAFs. METHODS: SEMSs were inserted into 20 patients with malignant CASs and four with malignant CAFs. Hospital records, the modified Medical Research Council dyspnea scale (mMRC) grade, performance status (PS), symptoms, procedure-related complications and survival after placement were retrospectively reviewed...

BACKGROUND: Airway involvement, such as airway invasion, compression, and tracheobronchoesophageal fistula (TEF), in esophageal cancer is associated with significant morbidity. However, the risk factors and outcomes of airway complications remain unclear, with limited evidence to guide management. METHODS: This retrospective analysis included 804 patients with a diagnosis of esophageal cancer from 1998 to 2018 at a tertiary care medical center (Singapore General Hospital, Singapore)...

BACKGROUND: Tracheobronchial stenting either alone or with esophageal stenting is often required for symptom palliation in obstructive or fistulous lesions of the airway due to esophageal cancer. There is limited evidence regarding dual stenting for lesions near the carina due to esophageal cancer. Hence, this study aims to evaluate the technical feasibility, outcomes, and complications of preplanned dual stenting in these patients. METHODS: This is a prospective observational study carried out over a period of 4 years (January 2015 to July 2019)...

BACKGROUND: Airway stenting is an efficacious approach in management of malignant airway disease (MAD) with improvement in survival outcome. OBJECTIVE: To determine the indications and long-term clinical outcomes of tracheobronchial stenting in patients with MAD. METHODS: A cross-sectional review of 51 patients who underwent airway stenting from June 2011 to June 2019 was done. Paired t-test was used to compare mean difference of clinical characteristics between pre- and post-airway stenting...

BACKGROUND: Thoracogastric airway fistula (TGAF) is a serious complication of esophagectomy for esophageal cancer. We conducted a systematic review of the appropriate therapeutic options for acquired TGAF. METHODS: We performed a literature search to identify relevant studies from PubMed, EMBASE, and Web of Science using the search terms "gastric airway fistula", "gastrotracheal fistula", "gastrobronchial fistula", "tracheogastric fistula", "bronchogastric fistula", "esophageal cancer", and "esophagectomy"...

INTRODUCTION: Dyspnea due to tracheal invasion by malignant tumors is a common oncological emergency that is difficult to manage, and a common cause of death among patients with advanced cancer. Bronchoscopy-guided intervention therapy under conventional ventilation is very risky for patients with severe central airway stenosis. Extracorporeal membrane oxygenation (ECMO) provides strong cardiopulmonary support, but is rarely used in bronchoscopy-guided interventional therapy. PATIENT CONCERNS: The patient had advanced esophageal cancer with metastases to the trachea and left and right main bronchi...

Background: Patients with advanced esophageal cancer and airway involvement have a poor prognosis. Self-expandable metallic stent (SEMS) implantation via bronchoscopy can immediately relieve airway stenosis and improve survival. The purpose of this study was to determine the factors that predict survival in patients with airway involvement due to advanced esophageal cancer after SEMS implantation. Methods: We conducted this retrospective study from February 2007 to October 2013 at a university hospital...

Primary esophageal cancer (EC) frequently presents as a locally advanced disease with airway involvement. Placement of combined esophageal and airway stents has been reported in small series to be an effective palliation strategy. Our aims are to present the largest cohort of EC patients who underwent double stent palliation and to evaluate the safety and efficacy of this approach. Longitudinal cohort study of patients with primary EC undergoing two-stage esophageal and airway stent placement at an oncology referral institute (January 2000-January 2019)...

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BACKGROUND: Airway invasion due to inoperable advanced esophageal cancers can sometimes cause serious complications includingairway stenosis and fistula, and compromise patients' QOL. We retrospectively evaluated the effect of tracheobronchial airway stentingfor airway stenosis due to inoperable advanced esophageal cancers. METHODS: Between 2010 and 2017, 9 patients with airway stenosis due to inoperable advanced esophageal cancers were treated by placement of a tracheo- bronchial airway stent...

Recent advance in bronchology and interventional pulmonology contributes to improve the quality of patient care in thoracic surgery. Narrow band imaging (NBI) combined with high definition bronchoscopy clearly visualize the aberrant tumor vessels on the mucosa of endobronchial malignancy. It helps the preoperative surgical planning for the clear bronchial margin during the surgery. The index of hemoglobin (IHb) show the approximate amount of hemoglobin within the mucosal surface and we use the IHb for the evaluation of local circulation of bronchial anastomosis after bronchoplasty...

BACKGROUND: Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. METHODS: We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea)...

Background Aerodigestive fistulae can be defined as abnormal communications between the gastrointestinal tract and the respiratory tract. Choking after meals, coughing, feeding difficulties, tachycardia, and persistent pneumonia are the main presentations. The aim of our study was to review our experience in the management of 27 cases of acquired aerodigestive fistulae of different types, levels, and management. Methods We conducted a retrospective observational study on 27 cases of fistulae between the respiratory and digestive tracts, which were managed in 2 hospitals in Saudi Arabia in the last 5 years...

Background: Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. Methods: Patients with malignant airway stenosis who underwent emergency intubation prior to airway stent placement from September 2005 to September 2015 in a single center were retrospectively reviewed...

BACKGROUND: Tracheal and bronchial stenosis is a life-threatening condition causing difficulty in breathing and even severe respiratory distress. The silicone tracheobronchial stents were placed using the rigid bronchoscopy into the trachea of severe dyspneic patients and they exhibited symptomatic improvement as well as a rise in the saturation of oxygen. The bronchial stents were applicable to many extensive malignant airway stenosis patients, such as those with esophageal cancer, lung cancer, and laryngeal cancer...

RATIONALE: Airway stenting is a well-established method that relieves symptoms and maintains airway patency in patients with airway obstruction. Serious complications caused by airway stents such as stent dislocation and airway obstruction during surgery are life-threatening. PATIENT CONCERNS: An 80-year-old man was treated with bronchial stent for left bronchus obstruction caused by metastatic esophageal cancer. During tracheostomy surgery, he suffered from acute tracheal obstruction caused by dislocated bronchial stent...

A man aged 51 years was referred for tracheobronchial stenting after a poorly differentiated oesophageal carcinoma had progressed to cause stridor. Bronchoscopy revealed a left vocal cord palsy and tumour infiltration into the trachea. A tracheobronchial stent was placed, and after distal migration was endoscopically resited. Returning from theatre, the patient developed severe upper airway obstruction that progressed to cause CO2 narcosis and loss of consciousness. A rapid sequence induction was initiated, and a Glidescope revealed bilateral vocal cord palsy with severe oedema causing an inability to pass a tube or stylet...