Study on curative effect and complications of covered stent in the treatment of esophageal cancer esophageal-tracheal (mediastinal) fistula after radiotherapy

Abstract

Objective To explore the curative effect and complications of covered stent in the treatment of esophageal cancer esophageal-tracheal (mediastinal) fistula after radiotherapy.Methods From August 2008 to July 2013,our department treated 250 cases of esophageal cancer patients with esophageal -tracheal fistula (mediastinal) after radiotherapy by stenting treatment under DSA guiding.Results 242 patients were successfully placed with stents,with review of imaging of the esophagus fistula closed,the success rate was 96.8％.8 cases were terminated the operation because of difficulty to tolerate the process or occurring hematemesis during the operation.25 cases should be placed stents for the second time due to reappearring fistula.All cases had foreign body sensation.10 cases with obvious chest pain,must be applied in the third step of analgesic drugs.5 cases died from esophageal bleeding within 2 weeks to 1 month (2％).Preoperative ~ function scores were higher than those postoperative (P ＜ 0.05) and KPS physical status scores decreased (P ＜ 0.05) statistically and significantly.Conclusion Covered stent in the treatment of esophageal cancer esophageal-tracheal (mediastinal) fistula after radiotherapy has high success rate,and could greatly improve the patients' quality of life.But it must be strictly grasping the indications,preoperative evaluation and preparation,soft and operation process,reducing the occurrence of complications. Key words: Covered stent; Esophageal cancer after radiotherapy; Esophageal-tracheal (mediastinal)fistula