S-21 Usefulness of Anchoring Technique for Prevention of Stent Migration in Esophagorespiratory Fistula = S-21 Usefulness of Anchoring Technique for Prevention of Stent Migration in Esophagorespiratory Fistula

다국어 초록 (Multilingual Abstract)

Background:?Coated SEMS (self-expandable metal stent) placement is the preferred therapy for malignant esophagorespiratory fistula (ERF) at present. Migration is more frequent in coated stent than uncoated stent. Migration can occur immediately after stent placement and is likely secondary to malpositioning, inadequate anchoring, soft nonconstricting tumors, or complete coating of the stent. The overall risk of migration is approximately 10%. To prevent migration, we have used the anchoring technique, called Shim’s technique in Korea, connecting stent to ear with silk thread.?Patients and Methods:?Seven patients with malignant ERF were included. ERF conditions liable to migration of stent were selected. The selection criteria were ERFs without stricture (3 cases), with short length of stenosis (2 cases), and with soft consistency around fistula (2 cases). The anchoring method was designed to hang stent to ear lobe. Auricle was used for a post to suspend stent by a thread until the fixation of stent on the esophageal wall. The coated stent was specially designed for antimigration which has small circumferential uncoated portion on proximal flange part of stent for fixation. After 5 days of stenting, we removed the anchoring silk from the stent. Sealing of fistula were assessed with clinical improvement and esophagogram.?Results:?There were no migrations after stent placement in all 7 cases. Symptoms of aspiration were improved in all 7 cases.?Conclusions:?The anchoring technique was useful for the prevention of stent migration in esophagorespiratory (ERF) cases, especially in the conditions that stent are apt to be migrated.