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Self-expandable metal stents for malignant dysphagia
1Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT.
The Australian and New Zealand Journal of Surgery
|October 9, 1999
Summary
Self-expandable metal stents effectively palliate malignant dysphagia in incurable esophageal strictures. This study shows significant improvement in swallowing function and successful fistula occlusion with acceptable complication rates.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- Malignant esophageal strictures cause severe dysphagia, significantly impacting quality of life.
- Palliative treatment options are crucial for patients with incurable esophageal cancer.
Purpose of the Study:
- To evaluate the efficacy and safety of self-expandable metal stents (SEMS) for palliation of malignant dysphagia.
- To assess outcomes including dysphagia relief, complication rates, and survival.
Main Methods:
- Retrospective evaluation of 82 patients (66 male, 16 female, median age 72) with malignant dysphagia treated with SEMS.
- Stent insertion performed under sedation and fluoroscopic guidance.
- Concurrent tracheo-esophageal fistulas were managed with stenting.
Main Results:
- Successful stent placement in 98% of patients.
- Significant improvement in mean dysphagia grade (3.2 to 1.8, P < 0.05).
- Early complications occurred in 7 patients; late complications in 21 patients. Tracheo-esophageal fistulas were successfully occluded.
Conclusions:
- Self-expandable metal stents offer a valuable palliative solution for patients suffering from incurable malignant dysphagia.
- SEMS provide significant functional improvement and effective management of associated fistulas.