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Expandable versus conventional esophageal prostheses: easier insertion may not preclude subsequent stent-related
R A Kozarek1, T J Ball, J J Brandabur
1Section of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington 98101, USA.
Gastrointestinal Endoscopy
|March 1, 1996
Summary
Expandable esophageal prostheses (EP) and conventional prostheses (CP) offer similar outcomes for esophageal fistulas and dysphagia. However, EP may have higher subacute complication rates, and patient prognosis remains poor regardless of stent design.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Device Comparison
Background:
- Expandable esophageal prostheses (EP) offer potential insertion advantages over conventional prostheses (CP).
- Clinical data comparing EP and CP outcomes are limited.
- Esophageal stent placement is crucial for managing dysphagia and fistulas.
Purpose of the Study:
- To compare the clinical outcomes and risks of expandable esophageal prostheses (EP) versus conventional prostheses (CP).
- To evaluate the efficacy of esophageal stents in patients with malignancy and esophago-airway fistulas.
- To assess the need for reintervention in patients receiving either type of esophageal prosthesis.
Main Methods:
- Retrospective review of esophageal stent placements from October 1983 to July 1995.
- Comparison of patient records for conventional prostheses (CP) and expandable prostheses (EP) groups.
- Analysis of insertion complications, dysphagia scores, fistula occlusion, complication rates, and survival.
Main Results:
- 47 patients received CP, and 38 received EP; fistula rates were similar between groups.
- Insertion complications, dysphagia improvement, and fistula occlusion rates were comparable.
- Subacute complication rates were higher in the EP group (80%) than the CP group (60%).
- Survival was similar for both groups, approximating 3 months.
Conclusions:
- Both CP and EP effectively manage dysphagia and tracheoesophageal fistulae.
- Patient prognosis remains poor irrespective of esophageal prosthesis design.
- Expandable prostheses (EP) may simplify insertion but persistent stent- and patient-related issues necessitate further intervention.
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