Treatment of malignant esophago-respiratory fistulas using self-expandable metal stents

One of the most severe complications of the advanced carcinoma of the esophagus is the break into the airways, creating a fistula. Aspiration through the fistula aspiration pneumonia are life threatening complication most cases they are in critical state and with high anesthesioiogical and surgical risk. These patients can't be of radically. The endoscopic treatment of esophago-respiratory fistulas (ERF) is a contemporary alternative of the treatment. This mini-invasive treatment covers the fistula minimal risk. From the patients with inoperable esophageal care treated in our hospital in the period 2003-2008, eight patients have had ERF. All of them have been treated by self-expandable metal stents (SEMS). The manipulations have been performed after informed patients' consent. Stents have been placed under deep sedation with combined endoscopic-radiological control, or partially covered stents with different design, with lengths from 90 to 140 mm, and diameters from 18 to 24 mm been placed. Total covering of the fistulas has been achieved and reducing of the clinical symptoms has been observed all patients. They have survived stenting without severe complications - bleeding, perforation or migration of the stent Covered SEMS and mini-invasive approach has successful despite severe illness and poor prognosis group. Our results give us reason to propose the conformation of endoscopic stenting with SEMS as a method of cho the treatment of the malignant esophago-respiratory fistulas