The role of metallic expandable stents in treating patients with inoperable esophageal stenosis: The experience of a Greek Cancer Hospital

 
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Annals of Gastroenterology
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The role of metallic expandable stents in treating patients with inoperable esophageal stenosis: The experience of a Greek Cancer Hospital (EN)

K. Tsamakidis, Alexandra Papadokostopoulou, A. Bazinis,E. Paraskevas, D. Xinopoulos, D. Dimitroulopoulos,

SUMMARY Aim: The evaluation of efficacy and safety of autoexpandable metal covered stend endoscopic placement in patients with malignant esophageal obstructions or stenoses. Patients and Method: We retrospectively analysed a total of 61 patients with malignant esophageal obstruction due to esophageal (n=25), pancreatic (n=1), breast (n=4) and lung cancer (n=29), primary esophageal melanoma (n=1) and recurrence of gastric adenocarcinoma after gastrectomy (n=1). The site of obstruction was in the upper (n=1), middle (n=34) and lower esophagus (n=23). In 9 cases gastro-esophageal junction was included. In all patients the tumour was considered nonresectable. Between 5/1997-6/ 2001, 61 Ultraflex covered stents and 4 Flamingo type were introduced endoscopically. 36 patients required dilation. Results: Stents were placed successfully in all cases. After 48h all patients were able to tolerate solid or semi-solid diet. Thirty-seven died 32+6 weeks later, none due to a cause related to the stent. During the follow-up period, 5 patients developed dysphagia due to food impaction. One stent 3 weeks after placement, in a case involving gastro-esophageal junction, migrated to the stomach and a new one was placed. Eight patients presented recurrent dysphagia. Four of these with tumour overgrowth at the distal end of the stenosis were treated with introspective application of Diamed laser (contact fiber) in a total of 13+6 sessions per patient (6782 joules, range 4380-10584 j per session). In the remaining 4 cases, a second stent was placed. No other side effects were noted. Conclusion: Placement of self-expanding metal stents is a safe and effective treatment modality for malignant esophageal obstruction. In case of expansion of the mass, laser therapy or placement of a second stent could be used. Key words: Esophageal malignant obstruction, metal stent, Diomed laser, palliative treatment (EN)

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Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Society of Gastroenterology (EN)

2007-03-19


Hellenic Society of Gastroenterology (EN)

1792-7463
1108-7471
Annals of Gastroenterology; Volume 17, No 1 (2004) (EN)



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