Combined oesophageal and airway stenting for malignant oesophageal strictures: the UK’s largest tertiary centre experience and development of a novel algorithm
Bibliographic record
Abstract
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 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".