Malignant tracheo esophageal fistula (TEF) are a serious complication of carcinomas of the esophgus and the lung. Constant aspirations and pneumonias lead usually to the rapid. Stent implantations, esophageal and/or tracheal are a palliative methods to close the fistulas.METHOD: In a prospective investigation patients with TEF, where in the period 01/99 to 126/02 a Nitinolstent was inserted, were observed.
In the period in 118 patients a TEF was diagnosed. In 112 (95 %) a successful closure of the fistula were possible, 58 % received a tracheal stent, (33 % an esophageal and 9% a doublestenting). At least soft food could take all patients to itself. In 6 patients a closure was not possible. The surviving amounts to 237 days (R 14–476) in the group, were the fistula could be closured, 39 days (R2–62) in the not successful treated group. All pts. fulfilled an Quality of Life (QoL)- questionnaire before and 4 weeks after stent placement. In the closured group the QoL improves significantly compared to not closured group.In the process 23 patients developed a recurrent fistula, all could be closed again by a further stenting. After stent placement it comes to 313 fistula associated hospital stays (3.1 day/patient), thereof 196 planned stent controls. In no case a pulmonary infection or a renewed aspiration were seen.
In patients with TBF a stent placement improved survival and QoL. Clinical symptoms are reduced, a life within the domestic area enabled and the number on hospital days reduced.
Nitinolstent implantation is an effective palliative therapy in malignant TEF.
F.J. Herth, None.