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Fístula Esofágica , Perfuração Esofágica , Doenças do Mediastino , Stents , Humanos , Doenças do Mediastino/cirurgia , Doenças do Mediastino/terapia , Doenças do Mediastino/complicações , Fístula Esofágica/cirurgia , Fístula Esofágica/etiologia , Fístula Esofágica/terapia , Perfuração Esofágica/cirurgia , Perfuração Esofágica/etiologia , Perfuração Esofágica/terapia , Doenças Pleurais/cirurgia , Doenças Pleurais/terapia , Doenças Pleurais/etiologia , Masculino , Fístula do Sistema Respiratório/cirurgia , Fístula do Sistema Respiratório/etiologia , Fístula do Sistema Respiratório/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Pessoa de Meia-Idade , Doenças do Esôfago , Ruptura EspontâneaAssuntos
Fístula Esofágica , Esofagectomia , Stents , Humanos , Esofagectomia/efeitos adversos , Stents/efeitos adversos , Masculino , Fístula Esofágica/etiologia , Fístula Esofágica/cirurgia , Fístula Esofágica/terapia , Neoplasias Esofágicas/cirurgia , Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica/cirurgia , Fístula Anastomótica/etiologia , Fístula Anastomótica/terapia , Pessoa de Meia-Idade , Esofagoscopia/métodosRESUMO
Fistulas in the upper gastrointestinal (GI) tract are complex conditions associated with elevated morbidity and mortality. They may arise as a result of inflammatory or malignant processes or following medical procedures, including endoscopic and surgical interventions. The management of upper GI is often challenging and requires a multidisciplinary approach. Accurate diagnosis, including endoscopic and radiological evaluations, is crucial to build a proper and personalized therapeutic plan, that should take into account patient's clinical conditions, time of onset, size, and anatomical characteristics of the defect. In recent years, several endoscopic techniques have been introduced for the minimally invasive management of upper GI fistulas, including through-the-scope and over-the-scope clips, stents, endoscopic suturing, endoluminal vacuum therapy (EVT), tissue adhesives, endoscopic internal drainage. This review aims to discuss and detail the current available endoscopic techniques for the treatment of upper GI fistulas.
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Endoscopia Gastrointestinal , Fístula Gástrica , Humanos , Endoscopia Gastrointestinal/métodos , Fístula Gástrica/terapia , Fístula Gástrica/cirurgia , Stents , Resultado do Tratamento , Fístula Esofágica/terapia , Fístula Esofágica/cirurgia , Fístula Esofágica/diagnóstico por imagem , Drenagem/instrumentação , Drenagem/métodos , Trato Gastrointestinal Superior/diagnóstico por imagemRESUMO
Limited studies have focused on the prognostic factors of esophageal respiratory fistula (ERF) associated with radiotherapy in patients with unresectable esophageal squamous cell carcinoma (ESCC). Between January 1st, 2014 and January 1st, 2021, we included patients who were initially diagnosed with unresectable ESCC and underwent radiotherapy. All patients were followed up for a period of 2 years after completing their radiotherapy treatment. The primary outcomes of the study were defined as death or severe adverse events. The survival curves of ERF were calculated using the Kaplan-Meier method. Cox proportional hazards model was employed to calculated the prognostic factors. A cohort of 232 patients underwent radiotherapy, of whom 32 patients experienced ERF. The median period from initial diagnosis of ESCC to ERF was 5.75 months, and the median period from ERF to the primary outcome was 4.6 weeks. Neck + upper chest location (odds ratio [OR] 3.305), high T stage (OR 1.765), esophageal stenosis (OR 1.073), high neutrophil to lymphocyte ratio (NLR) (OR 1.384) and platelet to lymphocyte ratio (PLR) (OR 1.765) were risk factors for the occurrence of ERF. Cox regression analysis suggested that tumor location (hazards ratio [HR] 3.572, 95% confidence interval [CI] 2.467-5.1), high T stage (HR 4.050, 95% CI 2.812-5.831), esophageal stenosis (HR 2.643, 95% CI 1.753-3.983), high PLR (HR 2.541, 95% CI 1.868-3.177) were independent prognostic factors for poor survival. Esophageal stenosis, neck + upper chest tumor location, high T stage and PLR predicted the prognosis of ERF in ESCC patients undergoing radiotherapy.
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Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Humanos , Masculino , Feminino , Carcinoma de Células Escamosas do Esôfago/radioterapia , Carcinoma de Células Escamosas do Esôfago/patologia , Carcinoma de Células Escamosas do Esôfago/complicações , Pessoa de Meia-Idade , Prognóstico , Neoplasias Esofágicas/radioterapia , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/complicações , Idoso , Fístula Esofágica/etiologia , Fatores de Risco , Estudos Retrospectivos , Modelos de Riscos Proporcionais , Neutrófilos , Estimativa de Kaplan-MeierAssuntos
Fístula Brônquica , Fístula Esofágica , Pneumonia Aspirativa , Humanos , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/diagnóstico , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/etiologia , Pneumonia Aspirativa/etiologia , Masculino , Pessoa de Meia-Idade , FemininoRESUMO
BACKGROUND: An aortoesophageal fistula can prove to be fatal. Salvage thoracic endovascular aortic repair as a bridging therapy and radical surgery with thoracotomy should be considered while treating aortoesophageal fistula without spontaneous closure. Moreover, it is essential to select a technique that reduces the risk of reinfection. Here we report a rare case of a ruptured thoracic aortic aneurysm related to esophageal perforation by a fish bone that led to massive hematemesis and shock, and the surgical treatment of an aortoesophageal fistula that developed after salvage thoracic endovascular aortic repair. CASE PRESENTATION: A 70-year-old Japanese female patient was admitted with hematemesis, thoracic pain, and shock related to esophageal perforation of a ruptured descending aortic aneurysm caused by fish bone aspiration and esophageal perforation 1 month previously. An emergency thoracic endovascular aortic repair was performed. Postoperatively, an aortoesophageal fistula that remained open and a food intake-related increase in the inflammatory response was noted. Radical blood-vessel prosthesis implantation and fistula closure were performed. The patient's postoperative course was favorable and the patient was discharged 22 days after the blood vessel prosthesis implantation. CONCLUSION: Such a case of rupture of a descending aortic aneurysm related to perforation by a fish bone and an aortoesophageal fistula is considerably rare. Thus, we report the therapeutic strategy of this particular case and review the relevant literature.
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Aneurisma da Aorta Torácica , Ruptura Aórtica , Procedimentos Endovasculares , Fístula Esofágica , Perfuração Esofágica , Humanos , Feminino , Fístula Esofágica/cirurgia , Fístula Esofágica/etiologia , Idoso , Procedimentos Endovasculares/métodos , Aneurisma da Aorta Torácica/cirurgia , Ruptura Aórtica/cirurgia , Perfuração Esofágica/cirurgia , Perfuração Esofágica/etiologia , Fístula Vascular/cirurgia , Fístula Vascular/etiologia , Implante de Prótese Vascular , Terapia de Salvação/métodos , Animais , Hematemese/etiologia , Doenças da Aorta/cirurgia , Doenças da Aorta/etiologia , Aorta Torácica/cirurgia , Resultado do Tratamento , Peixes , Correção Endovascular de AneurismaRESUMO
BACKGROUND: Catheter ablation for atrial fibrillation (AF) including pulmonary vein isolation and possibly further substrate ablation is the most common electrophysiological procedure. Severe complications are uncommon, but their detailed assessment in a large worldwide cohort is lacking. OBJECTIVES: The aim of this study was to determine the incidence of periprocedural severe complications and to provide a detailed characterization of the diagnostic evaluation and management of these complications in patients undergoing AF ablation. METHODS: Individual patient data were collected from 23 centers worldwide. Limited data were collected for all patients who underwent catheter ablation, and an expanded series of data points were collected for patients who experienced severe complications during periprocedural follow-up. Incidence, predictors, patient characteristics, management details, and overall outcomes of patients who experienced ablation-related complications were investigated. RESULTS: Data were collected from 23 participating centers at which 33,879 procedures were performed (median age 63 years, 30% women, 71% radiofrequency ablations). The incidence of severe complications (n = 271) was low (tamponade 6.8, stroke 0.97, cardiac arrest 0.41, esophageal fistula 0.21, and death 0.21). Age, female sex, a dilated left atrium, procedure duration, and the use of radiofrequency energy were independently associated with the composite endpoint of all severe complications. Among patients experiencing tamponade, 13% required cardiac surgery. Ninety-three percent of patients with complications were discharged directly home after a median length of stay of 5 days (Q1-Q3: 3-7 days). CONCLUSIONS: This large worldwide collaborative study highlighted that tamponade, stroke, cardiac arrest, esophageal fistula, and death are rare after AF ablation. Older age, female sex, procedure duration, a dilated left atrium, and the use of radiofrequency energy were associated with severe complications in this multinational cohort. One in 8 patients with tamponade required cardiac surgery.
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Fibrilação Atrial , Ablação por Cateter , Complicações Pós-Operatórias , Sistema de Registros , Humanos , Fibrilação Atrial/cirurgia , Masculino , Feminino , Ablação por Cateter/efeitos adversos , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias/epidemiologia , Incidência , Tamponamento Cardíaco/epidemiologia , Tamponamento Cardíaco/etiologia , Acidente Vascular Cerebral/epidemiologia , Fístula Esofágica/epidemiologia , Fístula Esofágica/etiologiaRESUMO
INTRODUCTION: Purulent pericarditis secondary to esophago-pericardial fistula is a serious complication that has been previously reported in patients with esophageal cancer treated with radio/chemotherapy and esophageal stenting. However, the presence of esophago-pericardial fistula as the first manifestation of advanced carcinoma of the esophagus is exceedingly infrequent. We report the case of a 61-year-old male who presented with sepsis, cardiac tamponade and septic shock who was found to have an esophago-pericardial fistula secondary to squamous carcinoma of the esophagus. Emergency pericardiocentesis was performed with subsequent hemodynamic improvement. The drained pericardial fluid was purulent in nature and cultures were positive for Streptococcus anginosus. A CT scan followed by upper gastrointestinal endoscopy with tissue biopsy confirmed the diagnosis of squamous cell carcinoma of the esophagus. A self-expanding covered stent was endoscopically placed to exclude the fistula and restore the esophageal lumen. In this report, we discuss some aspects related to the diagnosis and management of this serious clinical entity.
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Carcinoma de Células Escamosas , Fístula Esofágica , Neoplasias Esofágicas , Pericardite , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/complicações , Pericardite/microbiologia , Pericardite/etiologia , Pericardite/terapia , Pericardite/diagnóstico , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Fístula Esofágica/etiologia , Fístula Esofágica/diagnóstico , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico , Streptococcus anginosus/isolamento & purificação , Pericardiocentese , Stents , Tomografia Computadorizada por Raios X , Tamponamento Cardíaco/etiologiaAssuntos
Fontes de Energia Elétrica , Fístula Esofágica , Corpos Estranhos , Humanos , Fístula Esofágica/etiologia , Fístula Esofágica/diagnóstico , Corpos Estranhos/complicações , Masculino , Fontes de Energia Elétrica/efeitos adversos , Doenças da Aorta/etiologia , Doenças da Aorta/diagnóstico , Lactente , Fístula Vascular/etiologia , Fístula Vascular/diagnósticoRESUMO
Broncho-esophageal fistula (BEF) is a severe yet relatively rare connection between the bronchus and esophagus usually caused by esophageal and pulmonary malignancies. We present a case report of a 49-year-old man diagnosed with terminal lung carcinoma who developed a BEF. The thoracic computed tomography scan detected a mass in the left bronchi that partially covers and disrupts the bronchial contour in certain regions and extends to the esophageal wall. After thoroughly evaluating alternative treatment approaches, we opt for the stenting procedure due to the advanced stage of the tumor and the significantly diminished quality of life. The treatment involves the use of a partially covered metal stent that is known to exhibit lower potential to migrate. The treatment is highly successful, resulting in a significant enhancement of the patient's quality of life, a lengthening in his survival, and the ability to pursue additional palliative treatment options. In contrast to the typical prosthesis implantation, our procedure uses a direct endoscopic visualization for the proximal deployment of a partially covered stent, offering a cost-effective and radiation-free alternative that can be particularly beneficial for BEF patients in facilities without radiology services.
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Fístula Brônquica , Fístula Esofágica , Stents , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Esofágica/cirurgia , Fístula Esofágica/etiologia , Fístula Brônquica/cirurgia , Neoplasias Pulmonares/cirurgia , Resultado do Tratamento , Tomografia Computadorizada por Raios X/métodosRESUMO
BACKGROUND: Malignant esophageal fistula (MEF), which occurs in 5% to 15% of esophageal cancer (EC) patients, has a poor prognosis. Accurate identification of esophageal cancer patients at high risk of MEF is challenging. The goal of this study was to build and validate a model to predict the occurrence of esophageal fistula in EC patients. METHODS: This study retrospectively enrolled 122 esophageal cancer patients treated by chemotherapy or chemoradiotherapy (53 with fistula, 69 without), and all patients were randomly assigned to a training (n = 86) and a validation (n = 36) cohort. Radiomic features were extracted from pre-treatment CTs, clinically predictors were identified by logistic regression analysis. Lasso regression model was used for feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the clinical nomogram, radiomics-clinical nomogram and radiomics prediction model. The models were validated and compared by discrimination, calibration, reclassification, and clinical benefit. RESULTS: The radiomic signature consisting of ten selected features, was significantly associated with esophageal fistula (P = 0.001). Radiomics-clinical nomogram was created by two predictors including radiomics signature and stenosis, which was identified by logistic regression analysis. The model showed good discrimination with an AUC = 0.782 (95% CI 0.684-0.8796) in the training set and 0.867 (95% CI 0.7461-0.987) in the validation set, with an AIC = 101.1, and good calibration. When compared to the clinical prediction model, the radiomics-clinical nomogram improved NRI by 0.236 (95% CI 0.153, 0.614) and IDI by 0.125 (95% CI 0.040, 0.210), P = 0.004. CONCLUSION: We developed and validated the first radiomics-clinical nomogram for malignant esophageal fistula, which could assist clinicians in identifying patients at high risk of MEF.
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Fístula Esofágica , Neoplasias Esofágicas , Humanos , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/etiologia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/diagnóstico por imagem , Modelos Estatísticos , Nomogramas , Prognóstico , Radiômica , Estudos RetrospectivosRESUMO
Vascular rings are unusual congenital malformations. Among them, double aortic arch (DAA) is often difficult to diagnose due to its low incidence of symptoms. DAA can be associated with tracheal or esophageal compression and, in severe cases, could require tracheal intubation or chronic use of a nasogastric tube. This scenario favors the development of aortotracheal fistulas (ATF) or aortoe-sophageal fistulas (AEF). OBJECTIVE: To present a clinical case with an unusual association of DAA with ATF and to reinforce the importance of maintaining high diagnostic suspicion in patients with massive aerodigestive bleeding without an obvious source. CLINICAL CASE: A 32-week preterm newborn who required prolonged mechanical ventilation and presented intermittent episodes of massive oropharyngeal bleeding with hemodynamic compromise associated with lower airway obstruction without pulmonary hemorrhage. The patient underwent upper endoscopy and exploratory laparotomy without evidence of bleeding. Flexible nasopharyngolaryngoscopy and direct laryngoscopy also showed no abnormalities. A CT angiography showed complete DAA with indentation of the left dominant arch over the trachea, without severe stenosis or evidence of a fistula. AEF was suspected, so exploratory surgery was considered. However, the patient died before surgery due to a massive pulmonary hemorrhage. The autopsy revealed the presence of ATF. CONCLUSIONS: In patients with massive aerodigestive bleeding without an obvious source, the presence of DAA and possible AEF/ ATF should be considered. Imaging studies have a poor performance for this diagnosis, so surgery should be considered for diagnosis and treatment in these patients.
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Fístula Esofágica , Anel Vascular , Humanos , Recém-Nascido , Anel Vascular/complicações , Anel Vascular/cirurgia , Fístula Esofágica/diagnóstico , Fístula Esofágica/etiologia , Fístula Esofágica/cirurgia , Hemorragia Gastrointestinal/etiologiaAssuntos
Fístula Esofágica , Tuberculose dos Linfonodos , Humanos , Fístula Esofágica/etiologia , Fístula Esofágica/diagnóstico por imagem , Tuberculose dos Linfonodos/complicações , Masculino , Doenças do Mediastino/complicações , Doenças do Mediastino/etiologia , Doenças do Mediastino/diagnóstico por imagem , Mediastino , Tomografia Computadorizada por Raios X , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Aortoesophageal fistula (AEF) is a rare condition characterized by communication between the aorta and esophagus. AEF caused by an esophageal foreign body is even rare, and there is currently no recommended standard treatment protocol. We report a case of delayed aortic rupture after the endoscopic removal of a fish bone, which was successfully treated with a combined approach of vascular stenting and thoracic surgery. CASE PRESENTATION: A 33-year-old man presented to the hospital after experiencing chest discomfort for 3 days following the accidental ingestion of a fish bone. Under endoscopic guidance, the fish bone was successfully removed, and the patient was subsequently admitted for medical therapy. On the fourth postoperative day, the patient suddenly developed hematemesis, and chest computed tomography angiography revealed the presence of an AEF. This necessitated urgent intervention; hence, thoracic surgery was performed and a vascular-covered stent was placed. Following the surgical procedure, the patient received active medical treatment, recovered well, and was successfully discharged from the hospital. CONCLUSIONS: In patients with esophageal perforation caused by foreign bodies, hospitalization for observation, computed tomography angiography examination, early use of antibiotics, and careful assessment of aortic damage are advised. Thoracic endovascular aortic repair and esophageal rupture repair may have benefits for the treatment of AEF.
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Doenças da Aorta , Fístula Esofágica , Fístula Vascular , Masculino , Animais , Humanos , Adulto , Cirurgia Torácica Vídeoassistida/efeitos adversos , Doenças da Aorta/cirurgia , Doenças da Aorta/complicações , Fístula Esofágica/cirurgia , Fístula Esofágica/complicações , Hemorragia Gastrointestinal , Stents/efeitos adversos , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/etiologia , Fístula Vascular/cirurgiaRESUMO
BACKGROUND: While papillary thyroid carcinoma (PTC) generally exhibits a favorable prognosis post-surgery, the poorly differentiated subtype presents elevated rates of postoperative recurrence. Certain aggressive cases demonstrate invasive behavior, compromising adjacent structures and leading to a poor prognosis. This study delineates a unique case of postoperative PTC recurrence, complicated by esophageal fistula, that showed favorable outcomes following brief Vemurafenib treatment. PATIENT DESCRIPTION: A 64-year-old female patient underwent surgical resection for PTC, subsequently experiencing rapid tumor recurrence and development of an esophageal fistula. DIAGNOSIS: The patient was confirmed to have locally advanced PTC through intraoperative cytopathology. The cancer recurred postoperatively, culminating in the formation of an esophageal fistula. METHODS: The patient was administered Vemurafenib at a dosage of 960 mg twice daily following tumor recurrence. RESULTS: A 12-month regimen of targeted Vemurafenib therapy led to a substantial reduction in tumor size. Concurrently, the esophageal fistula underwent complete healing, facilitating successful removal of the gastrostomy tube. The tumor response was classified as stable disease. CONCLUSION SUBSECTIONS: Vemurafenib demonstrates potential as a targeted therapeutic strategy for recurrent PTC harboring the BRAFV600E mutation. This approach may effectively mitigate tumor dimensions and the associated risk of esophageal and tracheal fistulas.
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Carcinoma Papilar , Carcinoma , Fístula Esofágica , Neoplasias da Glândula Tireoide , Feminino , Humanos , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide , Vemurafenib/uso terapêutico , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/cirurgia , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Carcinoma/genética , Carcinoma Papilar/tratamento farmacológico , Carcinoma Papilar/cirurgia , Carcinoma Papilar/patologia , Recidiva Local de Neoplasia/patologia , PrognósticoRESUMO
Aorto-esophageal fistula (AEF) due to esophageal cancer (EC) is a life-threatening condition characterized by sudden hemorrhage, which often causes sudden death. To evaluate the efficacy and safety of thoracic endovascular aortic repair (TEVAR) for AEF due to EC, we performed a systematic review and meta-analysis. We searched the MEDLINE (PubMed) databases, the Cochrane Library databases, Ichushi-Web (the databases of the Japan Medical Abstract Society), and CiNii (Academic information search service of the National Institute of Information from Japan) from January 2000 to November 2023 for articles about TEVAR for an emergent aortic hemorrhage (salvage TEVAR [S-TEVAR]), and the prophylactic procedure (P-TEVAR). Six studies (140 cases) were eligible for meta-analysis. The 90-day mortality of S-TEVAR and P-TEVAR was 40% (95% CI 23-60, I2 = 36%) and 8% (95% CI 3-17, I2 = 0%), respectively. Post-S-TEVAR hemorrhagic and infectious complications were 17% (95% CI 3-57, I2 = 71%) and 20% (95% CI 5-57, I2 = 66%), respectively. Post-P-TEVAR hemorrhagic and infectious complications were 2% (95% CI 0-10, I2 = 0%) and 3% (95% CI 1-12, I2 = 0%), respectively. TEVAR for AEF due to EC may be a useful therapeutic option to manage or prevent hemorrhagic oncological emergencies.
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Aorta Torácica , Doenças da Aorta , Correção Endovascular de Aneurisma , Fístula Esofágica , Neoplasias Esofágicas , Fístula Vascular , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aorta Torácica/cirurgia , Doenças da Aorta/etiologia , Doenças da Aorta/cirurgia , Correção Endovascular de Aneurisma/efeitos adversos , Correção Endovascular de Aneurisma/métodos , Fístula Esofágica/etiologia , Fístula Esofágica/cirurgia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/complicações , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Fístula Vascular/cirurgia , Fístula Vascular/etiologiaRESUMO
INTRODUCTION: Whether airway-compromised airway-esophageal fistula (AEF) patients should undergo combined airway and esophageal stenting is controversial. This study was designed to evaluate the survival prognosis and poststent interventions in AEF patients with airways compromised by advanced malignancy with or without airway stents. METHODS: A retrospective analysis of the medical records, survival times, and poststent interventions of 17 patients with or without airway stents was performed. RESULTS: The causes of AEF were esophageal cancer (11/17, 64.7%), lung cancer (6/17, 29.4%), and thyroid cancer (1/17, 5.9%). All patients received a nasogastric tube (n = 12) or underwent gastrostomy (n = 5) to resume enteral nutrition. Thirteen patients underwent airway stent insertion (13/17, 76.5%), whereas four patients did not. Four patients with a high risk of stent migration received external stent fixation to the trachea. Three of the patients with stents suffered severe granulation tissue formation and needed repeated bronchoscopy interventions. In the stented group, none of the patients developed stent migration, and the overall median survival time was 9 months, compared with 1.25 months in the nonstented group (P = 0.04). Cox proportional hazards regression revealed that stent insertion, nasogastric tube insertion, and transcatheter bronchial artery chemoembolization were protective factors against death, whereas surgery-related fistula, fistula larger than 2 cm, continued chemotherapy, and age were risk factors for poor survival (P < 0.05). CONCLUSION: In airway-compromised AEF patients, airway stents and nasogastric tubes are probably the preferred treatments. Airway stenting is tolerable, and routine weekly poststent bronchoscopy is needed in the first month and depending on respiratory symptoms thereafter.