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