Causes and Treatment of Recurrent Dysphagia after Self-Expanding Metal Stent Placement for Palliation of Esophageal Carcinoma

Abstract

Recurrent dysphagia occurs in almost one-third of patients after stent placement. Repeat interventions for stent-related recurrent dysphagia are effective in over 90 % of patients. New innovations in stent design are needed to reduce the risk of stent-related recurrent dysphagia.

Malignant esophageal dysphagia palliation using insertion of a covered Ultraflex stent without fluoroscopy: a prospective observational study

“…In all six patients, the tumor was located in the lower esophagus/GEJ, and the original stent was positioned transcardially. This is comparable with rates (up to 28%) reported in other studies with SEMS inserted under fluoroscopy [6,[23][24][25][26][27][28]. Migration is more likely to occur with stents placed across the GEJ than with those placed for tumors more proximal in the esophagus, probably because the distal part of the stent projects freely into the fundus of the stomach and thus cannot fix itself to the esophageal wall [5].…”

Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy

“…As in other studies, there is no procedure related risk in experienced hands [11,12,13,14,15,16,17].…”

Fully covered removable nitinol self-expandable metal stents (SEMS) in malignant strictures of the esophagus: a multicenter analysis

“…Partially covered SEMS were associated with tumor overgrowth (12%), stent migration (15%), and food bolus obstruction (9%), which required reintervention in 30-40% of patients after 2-3 months of follow-up [14][15][16]. Newer generation partially covered SEMS also are associated with tumor overgrowth through the uncovered portion of the SEMS [17], thus, the introduction of fully covered stents.…”