Management of Malignant Strictures of the Cervical Esophagus with a Newly-Designed Self-Expanding Metal Stent

Cs, Shim; Jung, Ioan; Bhandari, Suryaprakash; Cb, Ryu; Sj, Hong; Kim, Jo; Jy, Cho; Js, Lee; Ms, Lee; Bs, Kim

doi:10.1055/s-2004-814555

Cited by 44 publications

(28 citation statements)

References 7 publications

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“…However, Verschuur et al found similar morbidity and recurrent dysphagia in patients with cervical and thoracic/abdominal esophageal stents [46]. Specific stents have been designed for the cervical esophagus, for example the ''Ultraflex'' (Boston Scientific) with a low radial expansion force [47], with a small proximal collar (5 mm) to reduce gastroesophageal reflux [48], or with a proximal delivery system in order to secure correct positioning of the stent (MITech Co, Pyontack, South Korea) [49]. Only a few rare cases of tracheal compression due to esophageal stent have been reported [50].…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal stenting: Current status and imaging features

Malgras

Dico

Pautrat

et al. 2015

Diagnostic and Interventional Imaging

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The use of stents in the gastrointestinal tract has been subjected to major changes. Initially, the use of stents was restricted to malignant strictures in patients with metastatic disease. But thanks to reduction of the morbidity and mortality rates, they are now used with curative intention and in patients with benign diseases after careful selection. However, for patients presenting with colon obstruction due to an advanced colon carcinoma, the mortality and morbidity are still high. The purpose of this review is to provide an overview of indications, techniques and further developments of the stents in the gastrointestinal tract and to highlight the predominant role of multidetector row computed tomography (MDCT) in the detection of potential complications.

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Section: Resultsmentioning

confidence: 99%

Gastrointestinal stenting: Current status and imaging features

Malgras

Dico

Pautrat

et al. 2015

Diagnostic and Interventional Imaging

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“…To overcome this, Dr Shim modified the SEMS with a smaller diameter funnel-shape proximal end. 1,2 In comparison with the standard SEMS, it has a shorter length of the proximal funnel (7 mm vs. 20 mm) and a narrower fully expanded diameter (18 mm vs. 20 mm). The modification decreases UES compromise and foreign body sensation.…”

Section: Discussionmentioning

confidence: 99%

“…The modification decreases UES compromise and foreign body sensation. 2 Our patient was treated first with a Niti-S stent because there was no modified SEMS available in Taiwan. The proximal end of the SEMS was placed at 20 cm from the incisor and achieved successful coverage of the TE fistula initially.…”

Section: Discussionmentioning

confidence: 99%

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Management of a cervical tracheoesophageal fistula with a modified self-expanding metal stent: Report of a case

Su¹,

Fong²,

Chen³

et al. 2011

Formosan Journal of Surgery

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KEYWORDScervical esophageal cancer; double esophageal stent; esophageal stent; self-expanding metal stent; tracheoesophageal fistula Summary Treatment of tracheoesophageal (TE) fistula is always a challenge, in particular TE fistula caused by malignancy. In the past decade, the development of a self-expanding metal stent (SEMS) has made management of esophageal stenosis or perforation much easier. Nevertheless, management of a cervical esophageal lesion is still debatable. A cervical esophageal stent may compromise the upper esophageal sphincter (UES) function and is usually listed as a contraindication. Here, a 53-year-old male had cervical esophageal cancer complicated with a TE fistula. After initial management with a SEMS, the patient had temporary improvement, but later suffered a recurrent TE fistula. The TE fistula was successfully managed by the placement of a second modified SEMS just below the UES without removal of the previous SEMS. The patient tolerated the procedure well and regained proper swallowing function.

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“…In fact, the placement of a stent in the cervical esophagus has traditionally been restricted because of the risk of potential adverse events such as tracheal compression, proximal migration, intractable pain and, most commonly, foreign body sensation (10,11). Nevertheless, some reports have suggested the possibility of treating this type of stricture by placing a stent in the cervical esophagus (12).…”

Section: Introductionmentioning

confidence: 99%

Endoscopically placed stents: a useful alternative for the management of refractory benign cervical esophageal stenosis

et al. 2017

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Introduction: Benign esophageal strictures are relatively frequent and can severely affect the quality of life of a patient. Stenting has been proposed for the treatment of refractory cases. Lesions affecting the cervical esophagus are more difficult to treat, and the placement of stents in this location has traditionally been restricted due to potential adverse events. The aim of this study was to describe the efficacy and safety of endoscopic stenting in the management of refractory benign cervical esophageal strictures (RBCES) in a single-center cohort study. Methods:We analyzed 12 patients with RBCES (Kochman's criteria) and severe dysphagia. We recorded previous endoscopic treatments, stricture characteristics and demographic data. The two types of stents used were fully covered self-expandable metallic stents (FCSEMS) and uncovered biodegradable stents (BDS). FCSEMS were removed eight weeks after placement, and BDS were followed-up until degradation. We assessed technical and clinical success, rate of stricture recurrence and adverse events.Results: The mean age of participants was 64 years (range 30-85). A total of 23 stents (13 FCSEMS and 10 BDS) were placed in 12 patients (median 1.92, range 1-4). The technical success rate was 96% (22/23 stents). Eight patients (66.6%) maintained adequate oral intake at the end of follow-up (median 33.3 months, range 3-84 months). Migration was recorded in 7/23 stents (30.4%) and epithelial hyperplasia in 4/23 stents (17.4%). No severe adverse events were noted. All patients complained of minor cervical pain after placement that was well controlled with mild analgesia.Conclusions: Endoscopic stent therapy seems to be effective and safe in the management of RBCES.

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Management of Malignant Strictures of the Cervical Esophagus with a Newly-Designed Self-Expanding Metal Stent

Cited by 44 publications

References 7 publications

Gastrointestinal stenting: Current status and imaging features

Gastrointestinal stenting: Current status and imaging features

Management of a cervical tracheoesophageal fistula with a modified self-expanding metal stent: Report of a case

Endoscopically placed stents: a useful alternative for the management of refractory benign cervical esophageal stenosis

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