Endoscopic stenting for stenosing cancer and digestive canal structures

Abstract

Background. The purpose of the work was to evaluate the effectiveness of the endoscopic stenting method in stenosing cancer and strictures of the digestive tract. Materials and methods. Since January 2015, endoscopic stenting has been performed in 12 patients using self-expanding nitinol stents with/without polymer coating manufactured by Boston Scientific, Ltd (USA) and uncoated nitinol stents manufactured by Garson (Korea). The study included 8 men (66.7 %) and 4 women (33.3 %) aged 51–80 years, (63.0 ± 4.2) years on average. Stenosing esophageal cancer was diagnosed in 5 patients, stenosing cancer of the gastric outlet — in 3, stenosing duodenal cancer — in one, esophageal stricture — in 3 people. In all patients, the indication for stenting was impaired patency of the digestive tract due to the underlying di-sease. Results. Nutrition was restored in all patients. In the group of stenosing esophageal cancer, the 30-day mortality rate was 20 %, the median survival rate was 9 months. Recurrence of dysphagia was diagnosed in one person, recanalization of the stent lumen was performed. In the group with stenosing cancer of the gastric outlet and duodenum, the 30-day mortality rate was 33.3 %, the median survival rate was 11 months. Impaired gastric emptying was detected in one patient, repeated stent-to-stent stenting was performed. In the group with esophageal stricture, one individual had stent migration, so the stent was repositioned. Conclusions. Endoscopic stenting with self-expanding nitinol stents in incu­rable patients with malignant stenoses of the esophagus, stomach, duodenum and in those with benign esophageal strictures is the surgery of choice, a safe and effective method that allows you to restore and continue natural nutrition and thereby improve the quality of life in incurable cases. Complications arising in the late period after stenting were found in 25 % of patients, and were corrected endoscopically.