1:54 PM Abstract No. 209 - Interventional treatment of thoracostomach-airway fistula after esophagogastrectomy with covered stents

Abstract

Purpose To evaluate the clinical value of treating thoracostomach-airway fistula after esophagogastrectomy with covered stents. Materials and Methods Through SCT and digital radiography with water-soluble medium, We diagnosed 22 patients with thoracostomach-airway fistula (6 thoracostomach-tracheal fistulas, 2 thoracostomach-carina fistulas, 13thoracostomach-left principal bronchial fistulas, 1 thoracostomach-right principal bronchial fistula). Covered stents were selected on the base of the site, size and number of thoracostomach-airway fistula.Under the fluoroscopic guidance, 24 stents were implanted in the 22 patients with thoracostomach-airway fistulas. Results Stent placement was technically successful in all patients. The stent completely sealed off the fistula in 18 of 22 patients, choking after drinking and eating vanished as soon as the fistula was closed and a normal diet could be swallowed after the placement of the stents. 4 of 22 patients had persistent aspiration symptoms due to incomplete closure (initial clinical failure). During follow-up, the fistula reopened in 11 of 22 patients with initial clinical success. 8 reopened fistulas were sealed off with stent placement and 3 were inserted a feeding nasoenteric tube and a nasogastric decompression tube. All patients died during follow-up, and mean survival was 14±4.56 weeks (range, 1-42 weeks) after stent placement. Conclusion The airway covered stent placement is an effective and safe treatment for thoracostomach-airway fistula.