Clinical Endoscopy

  • 제56권6호
  • /
  • Pages.761-768
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  • 2023
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer

  • Iatagan R. Josino (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Bruno C. Martins (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Andressa A. Machado (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Gustavo R. de A. Lima (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Martin A. C. Cordero (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Amanda A. M. Pombo (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Rubens A. A. Sallum (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Ulysses Ribeiro Jr (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo) ;
  • Todd H. Baron (Division of Gastroenterology and Hepatology, University of North Carolina) ;
  • Fauze Maluf-Filho (Department of Gastroenterology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo)
  • 투고 : 2022.11.04
  • 심사 : 2023.03.10
  • 발행 : 2023.11.30
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초록

Background/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMS-ERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer. Methods: This retrospective study was performed at the Instituto do Cancer do Estado de São Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study. Results: Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15-5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01-4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26-0.85; p=0.01). No difference was observed in overall survival. Conclusions: The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.

키워드

과제정보

The authors would like to thank all nurses, doctors, and other employees of the GI Endoscopy Department at the Instituto do Cancer do Estado de Sao Paulo. It requires great individual commitment to achieve great teamwork. We also appreciate all other professionals involved in the care of patients included in this study for their indirect contribution.

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