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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1421020

Efficacy and Risk Factors of Stent Placement in the Treatment of Malignant Tracheoesophageal Fistula

Provisionally accepted
Qingxia Wang Qingxia Wang 1Zhihong Duan Zhihong Duan 2Shiqi Liu Shiqi Liu 1Ruihua Shi Ruihua Shi 1*
  • 1 Southeast University Affiliated Zhongda Hospital, Medical School, Nanjing, China
  • 2 Department of Gastroenterology, BENQ Medical Center, Nanjing, China

The final, formatted version of the article will be published soon.

    Background: Due to the low incidence of malignant tracheoesophageal fistula and the paucity of relevant clinical studies, the benefits of stent implantation have not been well documented. It remains unclear which factors may affect fistula closure.Methods: Between January 2015 and January 2021, 344 patients who were diagnosed with malignant tracheoesophageal fistula in Zhongda Hospital, Southeast University were retrospectively enrolled. Demographics and clinical data were collected. Risk factors selected by univariate analysis for fistula closure were identified by multivariable logistic regression.Results: 288 patients were analyzed in this study of which 94 cases were treated conservatively, 170 cases were treated with an esophageal stent and 24 were treated with a tracheal stent. Among them, the delta Karnofsky's performance status score values (after 2 weeks/before treatment [p=0.0028], after 1 month/before treatment [p=0.0103]) were significantly different between conservative and stent treatment. There was a significant reduction of pneumonia incidence in the stenting group(33.53%) than conservative treatment group(77.05%) after one month(p＜0.0001). In addition, the closure of fistula were influenced by four independent risk factors: 1) treatment methods(p＜ 0.0001), 2) fistula size(p=0.0003), 3) preoperative white blood cell count (p=0.0042), and 4) preoperative Karnofsky's performance status score (p=0.0001).Stent implantation has become an effective method for malignant tracheoesophageal fistula compared to conservative treatment. Besides, stent implantation, smaller size of fistula, lower preoperative white blood cell count, and higher preoperative Karnofsky's performance status score suggest a better outcome.

    Keywords: Tracheoesophageal Fistula, Esophageal stent, Tracheal stent, conservative treatment, Risk factors

    Received: 02 May 2024; Accepted: 19 Jul 2024.

    Copyright: © 2024 Wang, Duan, Liu and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ruihua Shi, Southeast University Affiliated Zhongda Hospital, Medical School, Nanjing, China

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