Double esophagus and airways stents: Retrospective analysis in 33 patients

Introduction: Double stenting of esophagus and airways can be used for the palliative treatment of advanced tracheo-esophageal tumors. Aim: Evaluate complications and quality of life of patients treated with esophageal stent (OS) and tracheobronchial stent (TS). Methods: Retrospective analysis of patients treated with OS and TS at the Rouen University Hospital between 1997 and 2010. Results: Among 326 patients treated with OS, 33 received TS. Primary tumor was esophageal for 26 patients, pulmonary for 6 and both esophageal and pulmonary for one. 17 TS were placed for oeso-bronchial fistula, 5 for bronchial obstruction and 4 for both. Median Olgivie's dysphagia score was 4/4 before OS and 1 after. TS reduced dyspnea and eating cough in all cases except 3 (2 persistant fistula – 1 persistant dyspnea). Median survival after second stent insertion was 84 days. Hospitalization free median survival after second stent insertion was 42,5 days corresponding to 51% of survival. Lung cancer patients had shorter median survival than esophageal cancer patients 75 vs. 57 days. Early severe complications were 2 massive hemoptysis, 2 septic chock and 1 vocal chord paralysis. Complications occurring after 10 days of stenting were 3 hematemesis, 2 massive hemoptysis, 3 oeso-respiratory fistula, 1 septic chock and 1 tracheal compression. Mild early complications occurred for 11 patients including thoracic pain in 3 patients and 2 minor hemoptysis. Mild late complications occurred for 32 patients including 14 TS infections, 7 pneumonias and 6 alimentary obstructions of OS. Conclusion: OS and TS for advanced tracheo-esophageal tumors are associated with frequent infectious complications but improves patients' quality of life.