Endoscopic palliative intubation of the esophagus invaded by lung cancer

• Published in: Gastrointestinal endoscopy Vol. 36; no. 4; pp. 357 - 359
• Main Authors: Buset, M., Des Marez, B., Cremer, M.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.1990; Elsevier
• Subjects: Biological and medical sciences; Bronchial Fistula - etiology; Bronchial Fistula - therapy; Carcinoma, Non-Small-Cell Lung - complications; Esophageal Fistula - etiology; Esophageal Fistula - therapy; Esophageal Stenosis - etiology; Esophageal Stenosis - therapy; Esophagoscopy; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intubation - methods; Lung Neoplasms - complications; Male; Medical sciences; Middle Aged; Palliative Care - methods; Tumors; Human; Endoprosthesis; Prognosis; Respiratory disease; Lung; Stenosis; Digestive diseases; Tumor; Palliative treatment; Metastasis; Esophagus
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(90)71063-2

Thirty-two patients with esophageal involvement by lung cancer were managed by endoscopic intubation. In 22 patients with extrinsic esophageal strictures, the success rate of intubation was 91%, and 82% were discharged with their dysphagia relieved and esophageal patency restored. The mean survival rate was 4.4 months. In 10 patients with esophago-bronchial fistulas, 3 had the fistulous tract obliterated and lived a mean of 5 months. This low success rate of closing fistulas is due to failure to seal off the space between the stent and the fistula because of absence of tumor-associated stenosis. The overall morbidity rate was 28.1% (18.8% perforation, 6.3% hemorrhage, and 3.1% tracheal obstruction). The overall mortality rate was 18.8%. Although complications were more frequent than in primary esophageal tumors, endoscopic intubation was the only way to palliate this desperate condition and provided 66.6% of patients with relief of symptoms, nutritional improvement, and a mean survival time of 4.5 months.