Stent esofágico de nitinol en el manejo de las fístulas esofagorrespiratorias malignas

objective. esophagorespiratory fistulas, are a complication of malignant esophageal tumours. the efficacy of nitinol, self-expanding metal stents for palliation of malignant esophagorespiratory fistulas was investigated prospectively. methods. ten patients with malignant esophagorespiratory fistulas were treated with nitinol stents. in two patients the lesion was located in the proximal part of the esophagus. because of the fistula all patients suffered from dysphagia even for liquids. results. no technical problems during the implantation procedure of the stents occurred. in the control radiography with water-soluble contrast media, the fistulas were completely sealed in all patients. therefore the dysphagia improved significantly. all nitinol stents showed a sufficient expansion within 24 h after placement. severe early or late complications were not encountered, with the exception of tumor overgrowth in one patient about 15 weeks after stent placement. in three patients short term (3-6 days) retrosternal pain was observed, and one patient complained of slight foreign body sensation. one year later all 10 patients had died of advanced disease, with a median survival time of 106 days (range, 17-216 days). conclusions. nitinol stents are highly effective for palliative treatment of esophagorespiratory fistula and have a low complication rate. it seems that use of the nitinol stent can be considered a good therapeutic method for palliative endoscopic treatment of this high risk patient group.