Complications of Metallic Stent Placement in Malignant Esophageal Stricture and Their Management

Abstract

The complication rate of self-expandable metallic stent placement is high in inoperable esophageal cancer patients. Although some of these complications are life threatening, many of them can be managed successfully with endoscopic reintervention.

Treatment of complications caused by metallic stent placement in esophageal cancer

“…However, if symptomatic, the stent should be removed by endoscopy or surgical incision. [3] In our study, while an incomplete migration was observed in 3.7% of the patients, the stent displaced into the stomach in 2.9% of cases. While the stent was pulled back to its normal location by endoscope in all patients with incomplete migration, the stent was removed by employing gastrotomy after a mini-laparotomy in five of the eight patients with total migration to stomach.…”

“…[1,3,8,18] In our study, a re-intervention (new stent placement, removal of the stent, stent dilation, or removal of food residues) became necessary in 72 (26.9%) patients. Considering that the mortality rate was low (1.5%) and the mean survival rate was approximately six months in our study, we may conclude that esophageal stent provides significant palliation.…”

“…This complication has been reported in 10 to 20% of patients after an average of three months. [1,3,20] Coated stent placement may inhibit tumor ingrowth. However, it cannot prevent tumor overgrowth and benign hyperplastic tissue development on the edge of the stent.…”

“…[2] Self-expanding metallic stents (SEMS) constitute one of the most important methods of palliation in inoperable cases. [3] In this study, we aimed to present complications arising from selfexpanding metallic stents placed in patients with oesop hageal cancer and the treatment methods for these complications.…”

Esophageal Bypass Using a Gastric Tube for a Malignant Tracheoesophageal/Bronchoesophageal Fistula: A Report of 4 Cases

“…5 Furthermore, it is recommended that radiation therapy should precede stent placement for patients with locally advanced esophageal cancer with severe dysphagia, because the consequences of radiation therapy after stent placement often lead to complications such as bleeding, stent migration, and perforation of the esophagus. 6 However, previous radiotherapy and chemotherapy is often a contraindication for stent placement in patients with malignant tracheoesophageal/bronchoesophageal fistulas.…”