Long-term outcomes and complications of metallic stents for malignant esophageal stenoses

Thirty patients with malignant esophageal stenosis underwent Ultraflex esophageal stent deployment and were followed up for a maximum of 29 months from June 1995 to August 2001 in Tenri Hospital. Twelve stents were in the upper esophagus, and nine each in the middle and lower esophagus. The procedures were successful and dysphagia scores improved from 2.9 to 0.7. Major complications such as esophagorespiratory fistula, hematemesis, or airway compression occurred in 9 patients, more often in the upper esophagus than in other parts of the esophagus, with no statistical difference. There was a significant difference in the onset of major complications between the upper and middle esophagus, as well as between the upper and middle-lower esophagus (p < 0.05), but no difference in mean survival time between locations, or patients with or without major complications. These results demonstrate that esophageal stent deployment is effective for relieving dysphagia and associating malnutrition. But major complications may occur in the upper esophagus more often and earlier than in other parts.