Article
Self-expandable esophageal stents in management of pharyngeal fistula
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Published: | September 22, 2005 |
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Background: Pharyngeal fistula is one of the most common complications of laryngectomy and pharyngolaryngectomy. In patients with poorly healing defects, often as a result of radiotherapy, closure of the fistula is impossible, even using various surgical reconstruction techniques. The aim of the study is presentation of our experience in treatment of pharyngeal fistulae with self-expandable esophageal stents in cases, where various flap reconstruction techniques failed.
Method: There were 5 patients with pharyngeal fistula after pharyngolaryngectomy and 1 patient with pharyngeal fistula after subtotal tongue resection and laryngectomy treated with esophageal stent implantation. The procedure was performed under local anesthesia using x-ray guide.
Results: In all cases stent implantation resulted in closure of the fistula and enabled the patients to swallow normally without use of the stomach tube. Four patients died of the primary disease. Two patients from the group are still alive without the fistula (8 and 27 months after the procedure). In 2 cases a transposition of the prosthesis occurred, which was handled by means of second stent implantation.
Conclusions: 1. Stent implantation is an effective method of palliative treatment of pharyngeal fistulae in patients where reconstruction techniques have failed. 2. This method resolves the symptoms of the fistula immediately. 3. The complication risk of stent implantation is small. 4. Possible stent migration can occur.