Fistula closure technique using an esophageal stent and fixation method for gastrointestinal-airway fistula after esophageal cancer surgery.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Esophagus Pub Date : 2025-04-28 DOI:10.1007/s10388-025-01129-4

Koichi Okamoto, Yuta Sannomiya, Kazuyoshi Mitta, Akifumi Hashimoto, Hisashi Nishiki, Daisuke Kaida, Takashi Miyata, Toshikatsu Tsuji, Hideto Fujita, Noriyuki Inaki, Itasu Ninomiya, Hiroyuki Takamura

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引用次数: 0

Abstract

Background: The occurrence of a gastrointestinal-airway fistula after esophageal cancer surgery is a serious and fatal complication that can cause severe respiratory complications. It is a pathological condition requiring prompt intervention to avoid a fatal course. Conventionally, highly invasive surgical treatment has been selected for the treatment for gastrointestinal-airway fistula, but its difficulty and mortality risk cannot be neglected. Esophageal stent placement is useful as a nonoperative management for gastrointestinal-airway fistulas, but the success rate of fistula closure is not that high. Hence, an effective method that can solve technical problems to avoid intervention-related complications and increases the success rate of fistula closure by stent placement needs to be developed. We have achieved better results with our unique ingenuity for the management of esophageal stent placement; thus, we aimed to describe the details of the management methods.

Methods: Our technique used in stent placement included endoscopic insertion of the self-expandable metallic stent and the fixation of the stent with a nylon thread and a transnasal catheter on the face. With this ingenuity, it becomes possible to reduce stent migration, and an easy and quick adjustment of its position in case of stent migration can be possible.

Results: We have experienced successfully cured cases with our novel technique [five of seven cases (71.4%)] with a minimum indwelling period.

Conclusions: Our technique is feasible for use in the management of gastrointestinal-airway fistula after esophageal cancer surgery.

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食管癌手术后使用食管支架和固定方法封堵胃肠道-气道瘘的技术。

背景：食管癌术后发生胃肠道-气道瘘是一种严重且致命的并发症，可引起严重的呼吸系统并发症。这是一种病理状况，需要及时干预以避免致命的过程。传统上，高侵入性手术治疗是治疗胃肠道-气道瘘的首选方法，但其难度和死亡风险不容忽视。食管支架置入术是治疗胃肠道-气道瘘的一种非手术治疗方法，但瘘管关闭的成功率并不高。因此，需要开发一种有效的方法来解决技术问题，避免干预相关并发症，提高支架置入瘘道闭合的成功率。我们在食管支架置入术管理方面的独特创新取得了较好的效果；因此，我们旨在描述管理方法的细节。方法：我们使用的支架置入技术包括内镜下插入自膨胀金属支架，用尼龙线和经鼻导管在面部固定支架。有了这种独创性，就有可能减少支架的迁移，并且在支架迁移的情况下可以轻松快速地调整其位置。结果：7例患者中有5例（71.4%）成功治愈，留置时间最短。结论：本技术在食管癌术后胃肠道-气道瘘的治疗中是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.