Dual Airway and Oesophageal Stenting in Advanced Oesophageal Cancer with Lesions near Carina

Khan a et al.

J Bronchol Intervent Pulmonol Volume 27, Number 4, October 2020 286-292


What is the key question?

  • What is the technical feasibility, outcomes and complications of preplanned dual stenting for advanced esophageal cancer with lesions near the carina

What is the bottom line?

  • Advanced esophageal cancer is a significant cause of cancer-related morbidity and mortality with frequent local spread to the airway.
  • Endobronchial stenting is often required to circumvent extrinsic compression or direct airway involvement and can restore luminal integrity if concomitant tracehoesophageal fistula (TEF) exists.
  • Small case series exist which highlight the benefit of dual stenting.
  • However there is a paucity of data regarding dual stenting in patients with esophageal cancer with carinal lesions.
  • This prospective study included all patients undergoing dual stenting in the airway and esophagus with lesions near the carina (3 cms proximally and 5 cms distally).
  • Asymptomatic airway lumen compromise was evident in 31% patients
  • Twenty nine patients were included with airway obstruction due to infiltration in 20, external compression in 4 and isolated TEF in the remaining 5.
  • The majority of patients (23) had silicone stents placed.
  • There was significant improvement in both dyspnea and dysphagia after dual stenting (p<.001) with all patients immediately extubated.
  • Median survival post stenting was 97 days with mucus plugging requiring frequent suctioning (22), lower respiratory tract infection (11 with 3 requiring admission for IV antibiotics) and granulation tissue (9) the main complications

Why read on?

  • The authors further discuss the management of esophageal tumors with airway involvement including outcomes and complications