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Palliative esophageal stent placement using endoscopic guidance without fluoroscopy
Emmanuel Ben Soussan1, Michel Antonietti, Stéphane Lecleire
1Digestive Tract Research Group, Rouen University hospital Charles Nicolle, 76031 Rouen Cedex. Emmanuel.ben-soussan@chu-rouen.fr
Gastroenterologie Clinique Et Biologique
|November 19, 2005
Summary
Esophageal stent placement without fluoroscopy is safe and effective. Using a thin gastroscope for endoscopic control alone allows accurate stent insertion, improving dysphagia relief.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- Fluoroscopy is often unavailable in endoscopic units, causing treatment delays for esophageal stent placement.
- Alternative methods are needed to overcome fluoroscopy limitations and reduce patient transfer rates.
Purpose of the Study:
- To assess the safety and effectiveness of placing expandable esophageal metal stents under endoscopic control without fluoroscopy.
- To evaluate the feasibility of using a thin gastroscope for this procedure.
Main Methods:
- A prospective study included 33 patients requiring esophageal stent insertion.
- Esophageal stent placement was performed using a thin nasogastroscope (5.9 mm) with endoscopic control alone.
- Indications included malignant esophageal strictures, extrinsic compression, and esophago-respiratory fistulae.
Main Results:
- Stent placement was successful in 90% (30/33) of patients.
- Dysphagia relief was achieved within 48 hours, with a significant decrease in dysphagia score (3.1 to 1.2).
- Complications occurred in 11 patients, including one early death, pain, GERD, food impaction, tumor overgrowth, and a late fistula.
Conclusions:
- Expandable esophageal stents can be safely and accurately placed using endoscopy with a thin gastroscope.
- This technique eliminates the need for fluoroscopy, making it suitable for centers lacking this equipment.
- It also avoids patient exposure to X-ray radiation.