Palliative endoscopic therapy for cancer patients with esophageal fistula

Abstract

ObjectiveTo find an effective treatment for advanced cancer patients with esophageal fistula.MethodsFrom 1998 to 2006, we studied 42 patients with advanced esophageal cancer and 5 lung cancer patients with carcinomatous esophageal fistula (3 females, 44 males, aged 29–92 years). Ten patients with both esophageal cancer stricture and fistula were first dilated under endoscope, then a memory stent with a membrane was placed in the esophageal lumen. Others were treated only with a memory stent with a membrane, three of them with a large fistula (diameter >1.5 cm) were treated with bio-protein glue after placement of an esophageal metal stent.ResultsThe fistulas were covered by a stent and the patients could eat and drink immediately. Their quality of life was improved and their survival was prolonged, 44 out of 47 patients survived for >3 mo.ConclusionPlacement of esophageal stent with membrane or in combination with bio-protein glue through endoscope is an effective method for treating the bronchoesophageal fistula.