Palliative endoscopic interventions in esophageal cancer

Langer, Felix B.; Zacherl, Johannes

doi:10.1007/s10353-007-0360-2

Cited by 14 publications

(7 citation statements)

References 56 publications

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“…Esophageal stenting with self-expanding plastic or covered metal stents is believed to be a safe, easy, and effective treatment for stenosis or leakage of the esophagus. [20][21][22] However, currently available stents still have drawbacks with high rates of early (before 7 days after stenting) and late (after 7 days) complications reported. The major early complications reported are migration, perforation, and hemorrhage and are observed in up to 6%, 7%, and 6%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Outcome and complications of long-term self-expanding esophageal stenting

et al. 2012

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Esophageal stenting with self-expanding plastic or covered metal stents is believed to be safe and effective. As data on the outcome of patients with long-term stenting are not available, this study was conducted to evaluate the safety and efficacy of long-term esophageal stenting. From 2002 to 2008, 70 patients with long-term esophageal stenting for various indications from a prospective database were included into further analysis. The median stent period was 297 (124-1980) days during a mean follow-up time of 55 ± 52.4 months. Overall complication rate was 30% with a primary success rate of 97.2%. The stent-related total reintervention rate was 17.1%. There were no correlations between stent characteristics and the risk of complication or migration. No stent-related death was observed. Our data provide evidence that long-period esophageal stenting is safe and effective for various indications.

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Section: Discussionmentioning

confidence: 99%

Outcome and complications of long-term self-expanding esophageal stenting

et al. 2012

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“…Other strategies to manage stent related recurrent dysphagia include endoscopic tissue ablation with neodymium‐yttrium‐aluminium garnet laser (Nd:YAG laser), argon plasma coagulation (APC), photodynamic therapy (PDT), or intramural ethanol or cisplatin gel injection 21–25,41,42 . Nd:YAG laser and APC provide only short term palliation of dysphagia ranging from 4 to 6 weeks 21–24 . PDT is complicated by severe photosensitivity 21,25 .…”

Section: Discussionmentioning

confidence: 99%

“…Nd:YAG laser and APC provide only short term palliation of dysphagia ranging from 4 to 6 weeks 21–24 . PDT is complicated by severe photosensitivity 21,25 . Intramural ethanol or cisplatin gel injection also result in only short term palliation (3–8 weeks) 41,42 …”

Section: Discussionmentioning

confidence: 99%

“…The most common endoscopic interventions are thermal ablation or the placement of a second stent. Tissue ablation techniques are limited by a shorter duration of palliation and photosensitivity side effects 20–25 . Placement of a self‐expanding plastic stent (SEPS) in patients with malignant esophageal strictures offers a potential alternative approach to SEMS with the advantage of a lower cost 7,26 …”

Section: Introductionmentioning

confidence: 99%

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Self-expanding plastic stent to palliate symptomatic tissue in/overgrowth after self-expanding metal stent placement for esophageal cancer

Conio

Blanchi

Filiberti³

et al. 2010

Diseases of the Esophagus

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Self-expanding metal stents (SEMS) are used to treat obstructive malignancies of the esophagus or esophagogastric junction; however, a potential complication is recurrent dysphagia because of tissue in/overgrowth. The placement of a second SEMS is one strategy to re-establish patency of the esophageal lumen. We evaluated the safety and efficacy of an alternative and likely less costly approach: placing a self-expanding plastic stent (SEPS) to manage relapsing dysphagia in patients previously treated with a partially covered SEMS. From December 2007 to January 2009, 13 patients previously treated with a SEMS for malignant dysphagia underwent treatment by inserting a SEPS to palliate relapsing dysphagia, as a result of tissue in/overgrowth. Stenosis was located in the upper esophagus in one patient, in the middle in four patients, and in the lower esophagus in eight patients. Clinical evaluation was performed at the time of stent placement, after 1 week, and then, monthly until death. The SEPS was successfully placed in a single treatment session for all patients. No preliminary dilation was required, and no further treatment was necessary for any patient. Before stenting, the median dysphagia score was 4 (range 3-4), and 1 week later the score was 0 for all patients. The resolution of dysphagia persisted until patient death (from tumor progression). The mean survival after the SEPS insertion was 4 months (range 3-8). This case series supports the use of a SEPS to palliate dysphagia from tissue in/overgrowth of a SEMS. Future clinical trials with larger patient samples are warranted.

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“…Although different conservative and surgical therapy methods were presented in literature throughout the past century, no standardized treatment strategy with significant survival advantage could be settled [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Concerning surgery, major attendance is put on the type of resection and reconstruction with emphasis on postoperative complications and hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal reconstructions in 1200 patients with cancer at the pharyngesophageal junction

et al. 2010

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Zusammenfassung. Grundlagen: Karzinome am pharyngoösophagealen Ü bergang haben eine schlechte Prognose aufgrund der späten Symptommanifestation und Diagnose. Therapie der Wahl die Ö sophagusresektion mit gastrointestinaler Rekonstruktion bei resektablen Tumoren. Ziel dieser retrospektiven Studie war die Evaluation der Rekonstruktionsmethoden und deren Einfluss auf die postoperative Letalität, postoperative Komplikationen und funktionelle Ergebnisse. Methodik: Von 114 evaluierten Publikationen zwischen 1956 und 2008, wurden 33 Arbeiten in den Review inkludiert. Die postoperative Spitalsletalität, nichtchirurgische und chirurgische Komplikationen wurden ausgewertet. Weiters wurde der funktionelle Erfolg beurteilt. Ergebnisse: Von 1200 evaluierten Patienten erhielten 60,8 % einen Magenhochzug, 24,5 % erhielten ein Dünn-darminterponat und 14,7 % ein Dickdarminterponat. Die gesamte Spitalsletalität betrug 10,7 %. Patienten mit Dünndarminterponat hatten die niedrigste Spitalsletalität und die wenigsten nichtchirurgischen Komplikationen. Die geringsten chirurgischen Komplikationen und die besten funktionellen Resultate erzielten Patienten mit Magenhochzug. Schlussfolgerungen: Die segmentale Ö sophagusresektion mit Dünndarminterponat kann empfohlen werden, wobei diese Operation erfahrenen Spezialisten vorbehalten bleiben soll, da erhöhte chirurgische Komplikationen ein Risiko darstellen.

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Palliative endoscopic interventions in esophageal cancer

Cited by 14 publications

References 56 publications

Outcome and complications of long-term self-expanding esophageal stenting

Outcome and complications of long-term self-expanding esophageal stenting

Self-expanding plastic stent to palliate symptomatic tissue in/overgrowth after self-expanding metal stent placement for esophageal cancer

Gastrointestinal reconstructions in 1200 patients with cancer at the pharyngesophageal junction

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