Would you recommend stent placement upfront in a patient with cervical esophageal cancer and a TE fistula?

Malignant TE fistula is a complex problem which is often associated with a poor prognosis. Palliation with stenting can be problematic as the stent can erode and make the fistula larger. This is especially problematic with "kissing" stents in both the esophagus and the airway and/or in the setting o...

This is a challenging situation and I agree, prognosis does tend to be poor. I also tend to have a feeding G- or J- tube placed upfront. Most patients with such extensive local disease are already struggling nutritionally by the time I've seen them. That combined with the added morbidity of aspirati...