Endoscopy 2025; 57(S 02): S407
DOI: 10.1055/s-0045-1806037
Abstracts | ESGE Days 2025
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Combined oesophageal and airway stenting for malignant oesophageal strictures: the UK’s largest tertiary centre experience and development of a novel algorithm

Authors

  • J Gertner

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom
    2   Wellcome/EPSRC Centre for Interventional & Surgical Sciences, University College London, London, United Kingdom

  • M L Mullin

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom
    3   Department of Respirology, University of British Columbia, Vancouver, Canada

  • R Shea

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • N Aslam

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • M Banks

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • O F Ahmad

    2   Wellcome/EPSRC Centre for Interventional & Surgical Sciences, University College London, London, United Kingdom
    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • R Sweis

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • D Graham

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • N Navani

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • R Thakrar

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom

  • V Sehgal

    1   University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Aims Malignant oesophageal strictures can cause airway compromise and fistula formation [1]. Combined oesophageal and airway stenting is a potential treatment yet no guidelines exist [2]. This study aims to describe the outcomes of same-session oesophageal and airway endoscopic stenting for malignant strictures and propose an algorithm for intervention.

Methods A retrospective cohort study on patients undergoing same-session gastrointestinal (GI) and respiratory endoscopy at University College London Hospital, 2019-2023. All procedures were with anaesthetic-led propofol sedation. Data collected included malignancy type, luminal narrowing, completed interventions, complications, and mortality. The primary objective was to describe same-session procedures, with a focus on the frequency and type of stenting required.

Results 26 patients were identified with mean age of 63±9.6 years. Cancer type was oesophageal (81%) or lung (19%). The most common referral indication was dysphagia (42%); yet airway compromise was often seen on imaging (65%). Stent insertion included oesophageal only (35%), airway only (19%) and dual (27%). After oesophageal stenting, repeat bronchoscopy showed increased airway stenosis in 4 patients (25%). There was only one intraoperative complication, an oesophageal perforation. New tracheooesophageal fistula was the most common post-intervention complication (15%). Median time from malignancy diagnosis to death was 7.9 weeks.

Conclusions This study presents the first algorithm for endoscopic stenting in patients with malignant oesophageal stricture and airway involvement. Given the complexity of cases, joint upper GI and respiratory MDM is suggested to plan same-session endoscopy. Decision-making should be framed by patient-centred goals, as this group demonstrated poor prognosis.



Publication History

Article published online:
27 March 2025

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