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[Atkinson prosthesis in esophageal carcinoma. Radiologic study: when CT?]
P Bagnolesi1, A Cilotti, F Pinto
1Cattedra di Radiologia, Università di Pisa.
La Radiologia Medica
|June 1, 1992
Summary
Palliative Atkinson prosthesis placement for esophageal stenosis is effective, with low mortality and manageable complications. Conventional radiology is sufficient for most cases, while CT is reserved for complex situations.
Area of Science:
- Gastroenterology
- Oncology
- Radiology
Background:
- Esophageal and esophagocardial neoplastic stenoses often require palliative treatment when surgery is contraindicated.
- Endoscopic dilatation may be ineffective for advanced stenoses.
Purpose of the Study:
- To evaluate the efficacy and safety of palliative Atkinson prosthesis placement for neoplastic stenoses.
- To assess the role of different radiological methods in managing prosthesis-related complications.
Main Methods:
- Retrospective analysis of 92 patients treated with Atkinson prostheses.
- Radiological assessment including plain chest radiographs, esophagogastric studies, and CT scans (in 20 cases).
Main Results:
- 30-day mortality was 6.5%, unrelated to specific intubation complications.
- Mean survival was 3.6 months.
- Complications included perforation (2 cases), dislocation (9 cases), and obstruction.
- CT was superior for perforation detection but not routinely justified; conventional radiology was sufficient for dislocation and alimentary obstruction.
Conclusions:
- Atkinson prosthesis placement is a viable palliative option for esophageal neoplastic stenoses.
- Conventional radiology is adequate for managing most complications, with CT reserved for select complex cases.